• Cardiac Cath Lab/Interventional Radiology/EP Lab Skills Checklist

  • Answer Key:

    1. No Experience        2. Limited Experience        3. Experienced        4. Very Experienced

  • Age Specific
    Rows
  • Work Setting
    Rows
  • Cath Lab Procedures

  • Prepare
    Rows
  • Assist
    Rows
  • IR Procedures

  • Prepare
    Rows
  • Assist
    Rows
  • EP Lab Procedures

  • Prepare
    Rows
  • Assist
    Rows
  • Medications

  • Rows
  • Skills/Assessments

  • Cardiovascular
    Rows
  • Neurological
    Rows
  • Pulmonary
    Rows
  • Gastrointestinal
    Rows
  • Genitourinary
    Rows
  • General Skills
    Rows
  • I attest that this checklist represents a true reflection of my experience to the best of my knowledge.  By electronically signing this form I give my permission for it to be shared with facilities as a way to assess my skill level and be considered for employment opportunities.  

  •  -
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: