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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

EMR Software

1

2

3

4

Oxygen Administration

1

2

3

4

IV Therapy

1

2

3

4

Equipment

1

2

3

4

Neurology

1

2

3

4

Thoracic

1

2

3

4

Abdominal/Genitourinary

1

2

3

4

Gastrointestinal

1

2

3

4

Peripheral

1

2

3

4

General Procedures

1

2

3

4

Isolation and Infection Prevention

1

2

3

4

Assist with Insertion/Removal/Repair of:

1

2

3

4

Scrub the Following Procedures

1

2

3

4

Experience With Ages

1

2

3

4

Clinical Settings

1

2

3

4

Applicant Agreement

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Signature

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