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Skills Checklists

Congratulations on your decision to apply for an allied position with ClubStaffing! Before we can offer you an allied employment opportunity, an electronic skills assessment must be completed. From the skills checklist below, please locate the list that matches your specialty and complete the online form. Be sure to review your information thoroughly before clicking the submit button. Thank you!

ClubStaffing
5901 Broken Sound Pkwy.
Suite 450
Boca Raton, Florida 33487
Fax: (561) 367-0884


Speech Language Pathologist Skills Checklist

*
Denotes required field

This profile is for use by healthcare professionals in this discipline and specialty.  It will not be a determining factor for the program.
Please enter your full legal name as it appears on your Social Security Card.
First Name* Middle Name Last Name*
Last 4 of Social Security Number*
- -
E-Mail Address* Phone Number*
or
 
 
Please mark your level of experience
1. No theory and/or experience
2. Limited experience/need supervision and/or support
3. Experienced/minimal support needed to perform
4. Proficient/can perform independently
 
CLINICAL SETTING
1 2 3 4
 
Acute Care - Adult
 
Acute Care - Pediatric
 
Inpatient Rehabilitation Facility
 
Outpatient - Adult
 
Outpatient - Pediatric
 
Home Health Care - Adult
 
Home Health Care - Pediatric
 
Skilled Nursing Care
 
Long Term Acute Care (LTAC)
 
Psychiatric
 
School
 
Teletherapy: (enter setting)
 
ASSESSMENT – PEDIATRIC
1 2 3 4
 
Clinical Evaluation of Language Fundamentals (CELF)
 
Comprehensive Assessment of Spoken Language (CASL)
 
Goldman Fristoe Test of Articulation (GFTA)
 
Preschool Language Scale (PLS)
 
Rossetti Infant-Toddler Language Scale
 
Stuttering Severity Instrument (SSI)
 
Test of Language Development (TOLD)
 
Test of Pragmatic Language (TOPL)
 
ASSESSMENT – ADULT
1 2 3 4
 
Boston Diagnostic Aphasia Examination Experience
 
Brief Interview for Mental Status (BIMS)
 
Cognitive Performance Scale (CPS)
 
Flexible Endoscopic Evaluation of Swallowing (FEES)
 
Minnesota Test for Differential Diagnoses of Aphasia Experience
 
Modified Barium Swallow
 
National Outcomes Measurement Systems (NOMS)
 
Porch Index of Communicative Abilities Experience
 
Reading Comprehension Battery for Aphasia Experience
 
Rehab Institute of Chicago Eval. of Communication Exp.
 
Ross information Processing Assessment – Geriatric Experience
 
Western Aphasia Battery Experience
 
AREAS OF TREATMENT – PEDIATRIC
1 2 3 4
 
Alternative Augmentative Communication
 
Apraxia
 
Articulation/Phonology
 
Dysphagia
 
Fluency
 
Receptive/Expressive Language
 
Voice/Resonance
 
AREAS OF TREATMENT - ADULT/GERIATRIC
1 2 3 4
 
Aphasia
 
Dysarthria
 
Dysphagia
 
Memory/Cognition
 
Receptive/Expressive Language
 
Speech Generating Device
 
Voice/Resonance
 
DOCUMENTATION SYSTEMS/METHODS
1 2 3 4
 
Casamba
 
Care Manager
 
Rehab Optima
 
Cerner
 
Epic
 
McKesson
 
Meditech
 
School IEP Documentation Systems
 
BILLING DOCUMENTATION
1 2 3 4
 
ICD-10 Coding: Medical Diagnosis
 
ICD-10 Coding: Treatment Diagnosis
 
Medicaid/Medical
 
Medicare Part A
 
Medicare Part B
 
Patient Driven Payment Model (PDPM)
 
Patient Driven Groupings Model (PDGM)
 
OASIS
 
SUPERVISION
1 2 3 4
 
Supervises Clinical Fellows
 
Supervises SLPA
 
Supervises Rehab Staff
 
Age Specific
1 2 3 4
 
Neonate/Infant
 
Toddler/Preschool
 
School Age Children
 
Adolescents
 
Young/Middle Adults
 
Older Adults/Geriatrics
 
CERTIFICATIONS AND QUALIFICATIONS
 
Praxis Exam
 
CCC-SLP
 
Bilingual Endorsement Language:
 
Dementia Certification
 
Flexible Endoscopic Evaluation of Swallowing (FEES)
 
Lee Silverman Voice Treatment (LSVT)
 
Modified Barium Swallow Impairment Profile (MBSImP)
 
Non Violent Crisis Intervention (e.g. CPI)
 
CPR/BLS
 
Other: Specify
Speech Language Pathologist Skills Checklist, version 7

I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.

© 2018 AMN Healthcare, Inc. All rights reserved. Reproduction and distribution of these materials is prohibited without the expressed written authorization of AMN Healthcare, Inc.