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Please mark your level of experience
For the skills listed below please check if you are:
(E) Expert - serves as resource
(P) Proficient - performs daily or weekly
(L) Limited - less than 6 times a year
(N) No Experience - observed only
To StaffingMedical USA Employees:
Please rate your ability to perform these skills as accurately as possible
by checking the
appropriate boxes.
The information I have given here is true and accurate to the best of my
knowledge.
I authorize StaffingMedical USA to release this checklist to client hospitals
for the
purpose of placing me on a travel assignment.
Name
Date
Email
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