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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

General Skills

1

2

3

4

Assessment

1

2

3

4

Monitoring / Telemetry

1

2

3

4

Hemodynamic Monitoring

1

2

3

4

IV Therapy

1

2

3

4

Pulmonary

1

2

3

4

Neurological

1

2

3

4

Medication

1

2

3

4

Site Management / Sheaths

1

2

3

4

Assist with Removal of:

Patient Care

1

2

3

4

Interventional Procedures / Scrub

1

2

3

4

Emergency Procedures

1

2

3

4

Interventional Procedures / Circulate

1

2

3

4

Interventional Procedures / Monitor

1

2

3

4

Miscellaneous

Experience With Ages

1

2

3

4

EMRs

1

2

3

4

Applicant Agreement

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Signature

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