Your name
Your Email
Last 4 Of SSN
Date
E-Signature
I hereby certify that ALL information I have provided on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.
Data Entry: 0★★★★−
Medical Records - Entry: 0★★★★−
Medical Records - Maintenance: 0★★★★−
Electronic Medical Records - Entry: 0★★★★−
Electronic Medical Records - Maintenance: 0★★★★−
Gathers data and runs reports: 0★★★★−
Patient Files - Set up, report and record: 0★★★★−
Completion and filing/distribution of reports: 0★★★★−
Schedules appointments/tests: 0★★★★−
Takes, distributes and prioritizes messages: 0★★★★−
Assists physicians with procedures: 0★★★★−
Assists nursing staff: 0★★★★−
Prepares patients for appointments and exams: 0★★★★−
Gathers patient history and VS: 0★★★★−
Gives injections as directed: 0★★★★−
Performs phlebotomy skills: 0★★★★−
Collects lab. Specimens: 0★★★★−
Administer EKGs: 0★★★★−
Completes specimen testing, i.e. glucose, strep, mono, flu: 0★★★★−
Prepares and maintains supplies and equipment: 0★★★★−
Knows utilization of patient care equipment/instruments: 0★★★★−
Develops patient, physician and peer relationships: 0★★★★−
Maintains/protects patient confidentiality: 0★★★★−
Adheres to facility policies and procedures: 0★★★★−
Adheres to OSHA, HIPPA, legal and ethical guidelines: 0★★★★−
Adheres to quality protocol and standards: 0★★★★−
Attends and participates in required meetings: 0★★★★−
Schedules appointments, tests and treatments: 0★★★★−
Responds to emergencies in a calm organized manner: 0★★★★−
Understands/follows the reporting process acording to the chain of command: 0★★★★−
Medic, Medic Soft: 0★★★★−
Centricity: 0★★★★−
Medical Manager: 0★★★★−
HIS: 0★★★★−
Word, Word Perfect: 0★★★★−
Soft: 0★★★★−
Windows: 0★★★★−
IDX: 0★★★★−
Meditech: 0★★★★−
Newborn (birth to 30 days): 0★★★★−
Infant (31 days to 1 year): 0★★★★−
Toddler (ages 2-3 years): 0★★★★−
Preschooler (ages 4-5 years): 0★★★★−
Childhood (ages 6-12 years): 0★★★★−
Adolescents (ages 13-21 years): 0★★★★−
Young Adults (ages 22-39 years): 0★★★★−
Adults (ages 40-64 years): 0★★★★−
Older Adults (ages 65 -79 years): 0★★★★−
Elderly (ages 80+ years): 0★★★★−