We heard you've got skills

Home Health

  • 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 Fusion Medical Staffing.

    • 0 = Not Applicable
    • 1 = No Experience
    • 2 = Some Experience
    • 3 = Intermittent Experience
    • 4 = Experienced
    • 5 = Very Experienced

    *Required fields

  • Age 0 1 2 3 4 5
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  • General Skills 0 1 2 3 4 5
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  • Cardiovascular 0 1 2 3 4 5
  • Assessment:

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  • Interpretation of Lab Results:

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  • Equipment & Procedures:

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  • Care of Patient With:

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  • Medication Administration:

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  • Pulmonary 0 1 2 3 4 5
  • Assessment:

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  • Equipment & Procedures:

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  • Care of Patient With:

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  • Medication Administration:

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  • Neurological 0 1 2 3 4 5
  • Assessment:

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  • Equipment & Procedures:

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  • Care of Patient With:

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  • Medication Administration:

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  • Orthopedics 0 1 2 3 4 5
  • Assessment:

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  • Equipment & Procedures:

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  • Medication Administration:

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  • Gastrointestinal 0 1 2 3 4 5
  • Assessment:

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  • Equipment & Procedures:

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  • Care of Patient With:

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  • Renal/Genitourinary 0 1 2 3 4 5
  • Assessment:

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  • Interpretation of Lab Results:

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  • Equipment & Procedures:

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  • Care of Patient With:

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  • Endocrine/Metabolic 0 1 2 3 4 5
  • Assessment:

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  • Interpretation of Lab Results:

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  • Equipment & Procedures:

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  • Care of Patient With:

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  • Medication Administration:

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  • Wound/Skin Care Management 0 1 2 3 4 5
  • Assessment:

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  • Equipment & Procedures:

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  • Care of Patient With:

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  • Oncology 0 1 2 3 4 5
  • Assessment:

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  • Interpretation of Lab Results:

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  • Equipment & Procedures:

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  • Care of Patient With:

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  • Medication Administration:

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  • Infectious Disease 0 1 2 3 4 5
  • Assessment:

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  • Interpretation of Lab Results:

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  • Equipment & Procedures:

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  • Care of Patient With:

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  • Medication Administration:

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  • Psychiatry 0 1 2 3 4 5
  • Assessment:

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  • Care of Patient With:

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  • Women’s Health/Maternal-Infant Care 0 1 2 3 4 5
  • Assessment:

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  • Care of Patient With:

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  • Pediatrics 0 1 2 3 4 5
  • Assessment:

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  • Equipment & Procedures:

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  • Care of Patient With:

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  • Pain Management 0 1 2 3 4 5
  • Assessment:

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  • Equipment & Procedures:

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  • Care of Patient With:

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  • Palliative and End-of-Life Care 0 1 2 3 4 5
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  • Patient and Family Teaching 0 1 2 3 4 5
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  • Miscellaneous 0 1 2 3 4 5
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  • Case Management 0 1 2 3 4 5
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  • Experience With 0 1 2 3 4 5
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  • Documentation 0 1 2 3 4 5
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  • The information I have given is true and accurate to the best of my knowledge, and I hereby authorize Fusion Medical Staffing to release this Skills Checklist to staffing clients of Fusion Medical Staffing. Submit this skills evaluation with your initial application. To be updated annually.

  • Date Format: MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.
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