Skills Checklist

This Skills Checklist is a self-evaluation to assess your recent experience in various clinical settings focusing on the past 2 years.

0 = No Experience
1 = Some Experience
2 = Intermittent Experience
3 = Experienced
4 = Very Experienced

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AGE OF PATIENTS CARED FOR

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Newborn/Neonate (birth to 30 days)
Infant (1 month to 1 year)
Toddler (1 year to 3 years)
Preschooler (3 years to 5 years)
School Age Child (5 years to 12 years)
Adolescents (12 years to 18 years)
Young Adults (18 years to 39 years)
Middle Adults (39 years to 64 years)
Older Adults (64+ years)
Elderly Adults (Over 79+ years)

GENERAL SKILLS

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Standard Precautions
Isolation Precautions
Pediatric Respiratory/ Cardiac Arrest
Adult Respiratory/ Cardiac Arrest

WORK SETTING

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Adult Acute Care
Adult Outpatient
Pediatric Acute Care
Pediatric Outpatient
Bedside/ Portable Procedures
ER/ Trauma
OR

CHEST AND THORAX

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Chest Routine
Chest SP
Ribs
Chest Lateral Decubitus
Sternum
Upper Airway (Soft-Tissue Neck)

UPPER EXTREMITY

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Thumb or Finger
Hand
Wrist
Forearm
Elbow
Humerus
Shoulder
Trauma
Clavicle
Scapula
AC Joints

LOWER EXTREMITY

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Toes
Foot
Ankle
Knee
Tibia-Fibula
Femur
Trauma
Patella
Calcaneus

HEAD

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Skull
Paranasal Sinuses
Facial Bones
Orbits
Zygomatic Arches
Nasal Bones
Mandible
TMJ

SPINE AND PELVIS

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Cervical Spine
Thoracic Spine
Lumbar Spine
Sacrum and/ or Coccyx
Cross-Table Lateral Spine
Pelvis
Hip
Cross-Table Lateral Hip
Scoliosis Series
Sacroiliac Joints

ABDOMEN

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Abdomen Supine (KUB)
Abdomen Upright
Abdomen Decubitus

FLUOROSCOPY STUDIES

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Upper GI Series, Single or Double Contrast
Contrast Enema, Single or Double Contrast
Small Bowel Series
Esophagus
Cystography/ Cystourethrography
ERCP
Myelography
Arthrography
Hysterosalpingography

MOBILE RADIOGRAPHIC STUDIES

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Chest
Abdomen
Orthopedic

EQUIPMENT

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GE
Fuji
Siemens
Toshiba
Hitachi
Portables
C-Arm

EMR

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eClinicalworks
EPIC
McKesson
Care 360
Allscripts
Cerner
GE
Optum Insight
NextGen
Greenway

PACS

Rows	0	1	2	3	4
Ambra Health
Sectra
Infinitt
IBM Merge
McKesson
Philips
FujiFilm
Impax
Centricity
Carestream Vue
Clarity
eRad PACS
Syngo

Position Category

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Total Years of Experience

First Name

Last Name

Social Security #

Date of Birth

Email

Phone

Attestation

I certify that the information provided above accurately reflects education received and my experience in each of the clinical areas identified, particularly within the last 2 years. I hereby authorize Alliant Personnel Resources (The Company) to collect, store, and release any information that I have provided in this Skills Checklist and/or any other documentation and information they have collected or that I have submitted in any form to its parent company(s), its subsidiaries, or other subcontractors/its service providers as it deems necessary in its business operations as well as to individuals and companies in relation to consideration of employment as a Healthcare Professional with those companies and individuals. I acknowledge that The Company will take precaution and care to protect my personal information that is collected/stored/shared but cannot guarantee permanent data security and I release The Company from all related liability for damages or punitive liability.

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Skills Checklist - X-Ray Tech