• Lab/MLT Skills Checklist

  • Answer Key:

    1. No Experience

    2. Limited Experience

    3. Experienced

    4. Very Experienced

  • Work Settings
    Rows
  • Blood Bank
    Rows
  • Chemistry
    Rows
  • Hematology/Coagulation
    Rows
  • Immunology/Serology
    Rows
  • Microbiology
    Rows
  • Urinalysis
    Rows
  • Phlebotomy
    Rows
  • General Equipment
    Rows
  • Lab Information Systems
    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: