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Skills Checklist

Self Evaluation

This self evaluation is for assessing your experience in specific clinical areas. This self evaluation will not be a determining factor in accepting your application to become an employee of Springboard Health.


Please rate yourself using the following criteria:


1 = No Experience, 2 = Some Experience, 3 = Experienced, 4 = Very Experienced


Specialty

Abdominal

1

2

3

4

OB & Gynecology

1

2

3

4

Interventional

1

2

3

4

Neonatal

1

2

3

4

Neurosonology

1

2

3

4

Small Parts

1

2

3

4

Vascular

1

2

3

4

Echo

1

2

3

4

Experience in Primary Areas

1

2

3

4

Age Specific Practice Criteria

1

2

3

4

EMR

1

2

3

4

Applicant Agreement

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Signature

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