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Skills Checklists

Before you can begin applying for NurseChoice assignments, you need to complete a skills checklist. Required by hospitals, this mandatory form highlights your skills, proficiencies and experience in your specialty. The quickest and easiest way to complete your skills checklist is online. Just select your specialty from the list below, enter the necessary information on the form and click to submit. Once we receive your completed skills checklist you will be one step closer to finding a rewarding travel assignment that meets your needs.


Phlebotomy Skills Checklist

*
Denotes required field

This profile is for use by healthcare professionals in this discipline and specialty.  It will not be a determining factor for the program.
Please enter your full legal name as it appears on your Social Security Card.
First Name* Middle Name Last Name*
E-Mail Address* Phone Number*
 
 
WORK SETTINGS
1 2 3 4
 
Acute Setting
 
Free Standing Lab
 
Reference Lab
 
PHLEBOTOMY
1 2 3 4
 
Adult Venipuncture
 
Arterial Draw
 
Bleeding Time
 
Blood Alcohol Collection
 
Blood Culture Collection
 
Butterfly Draw
 
Centrifuge Operation
 
Dermal Stick (Finger/Heel)
 
Drug Screening Collection
 
Pediatric Venipuncture
 
PPE Equipment (Gloves/Mask, etc.)
 
Tube Types and Usage
 
LAB INFORMATION SYSTEMS
1 2 3 4
 
Cerner
 
Horizon
 
Meditech
 
Orchard
 
Sunquest
 
Other: Specify
 
Other: Specify
 
AGE SPECIFIC /POPULATION-BASED CARE
1 2 3 4
 
Neonate/Infant
 
Toddler/Preschool
 
School Age
 
Adolescents
 
Young/Middle Adults
 
Older Adults/Geriatrics
 
CERTIFICATIONS (Current at time of completing this form)
 
Cert. Phlebotomy Technician (CBT-ASCP)
 
BLS
 
Other: Specify
 
Other: Specify
Phlebotomy Skills Checklist, version 1

I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. Falsification of any information provided, will result in being ineligible to travel with AMN. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.

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