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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


PT/PTA 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 experience; requires education, training and supervision
2. Intermittent experience; may need support or supervision
3. Proficient; consistent experience, independent
4. Expert level; can teach/supervise others
 
CLINICAL SETTING
1 2 3 4
 
Acute Care - Adult
 
Acute Care - Pediatric
 
Rehabilitation Facility
 
Outpatient
 
Home Health Care - Adult
 
Home Health Care - Pediatric
 
Skilled Nursing Care
 
Long Term Acute Care (LTAC)
 
School
 
Teletherapy: (enter setting)
 
MODALITIES/MANUAL SKILLS/THERAPIES
1 2 3 4
 
Adaptive Equipment
 
Aquatic Therapy
 
Biofeedback
 
Bracing/Joint Immobilization
 
Compression Stockings - Fitting
 
Diathermy
 
Dry Needling
 
Elastic Therapeutic Taping Techniques
 
Electrical Stimulation
 
Extremity Mobilization
 
Gait Analysis
 
Iontophoresis
 
Manual Therapy - Joint Mobilization
 
Manual Therapy - Soft Tissue
 
Mechanical Traction
 
Muscle Energy Techniques
 
Myofascial Release
 
Pressure Force Plate
 
Spinal Mobilization
 
Strength and Endurance Training
 
TENS
 
Therapeutic Exercise/Home Programs
 
Ultrasound
 
Evaluation Tools
1 2 3 4
 
Biodex
 
Electromyography/Nerve Conduction Velocity
 
Environmental/Home Assessment
 
Fall Risk Assessment
 
Wellness Assessment
 
Wheelchair/Equipment Assessment
 
Work Capacity
 
ORTHOPEDICS
1 2 3 4
 
ACL Rehabilitation - Pre/Post Surgical
 
Ankle Sprain/Strain
 
Cervical Spine
 
Elbow/Epicondylitis
 
Fractures
 
Hand/Wrist
 
Hip Bursitis
 
ITB Pain Syndrome
 
Lumbar Spine
 
MCL
 
Meniscus Injury/Repair
 
Osteoarthritis
 
Patellofemoral Pain Syndrome
 
PCL
 
Plantar Fasciitis
 
Return to Sport Criteria
 
Return to Work Criteria
 
Rheumatoid Arthritis
 
Rotator Cuff Rehab
 
Scapular Dyskinesis
 
Scoliosis
 
Shoulder Impingement
 
Thoracic Outlet Syndrome
 
Thoracic Spine
 
Total Joint Replacement
 
Transmandibular Joint Dysfunction
 
NEUROLOGIC
1 2 3 4
 
Benign Paroxysmal Positional Vertigo
 
Brain Injury
 
Chronic Pain
 
CVA
 
Degenerative Diseases
 
Head Trauma/Concussion
 
Multiple Sclerosis
 
Parkinson's Disease
 
Spinal Cord Injury
 
Vestibular Rehabilitation
 
PROSTHETICS/ORTHOTICS
1 2 3 4
 
Above/Below Knee Prosthetics
 
Ankle/Foot Orthosis
 
Dynamic Splints
 
Pediatric Prosthetic/Orthotic Assessment
 
Residual Limb Care
 
Static Splints
 
PEDIATRICS
1 2 3 4
 
Cerebral Palsy
 
Early Intervention Programs
 
Gait Training
 
Gross Motor Assessments
 
Neurodevelopmental Treatment
 
Scoliosis Assessment/Intervention
 
Sensory Assessment
 
Spinal Bifida
 
WOUND CARE
1 2 3 4
 
Arterial Ulcers
 
Burn Management
 
Diabetic Ulcers
 
Pressure Ulcers
 
Surgical Aftercare
 
Venous Ulcers
 
CARDIOPULMONARY
1 2 3 4
 
Asthma
 
Congestive Heart Failure
 
COPD
 
Coronary Heart Disease
 
Cystic Fibrosis
 
Hypertension
 
Myocardial Infarction
 
Phase 1 Cardiac Rehab - Acute Post Surgical
 
Phase 2 Cardiac Rehab - Post Acute Discharge
 
Phase 3 Cardiac Rehab - Outpatient
 
Pneumonia
 
Postural Drainage Techniques
 
TECHNOLOGY
1 2 3 4
 
Care Manager
 
Casamba (Smart)
 
Cerner
 
Epic
 
McKesson
 
Meditech
 
Rehab Optima
 
School IEP Documentation Systems
 
WebPT
 
Other (fill in the blank)
 
Other (fill in the blank)
 
EMR Conversion
 
EMR Conversion
 
BILLING/DOCUMENTATION
1 2 3 4
 
ICD-10 Coding: Medical Diagnosis
 
ICD-10 Coding: Treatment Diagnosis
 
Medicaid/Medical
 
Medicare Part A
 
Medicare Part B
 
OASIS
 
Patient Driven Groupings Model (PDGM)
 
Patient Driven Payment Model (PDPM)
 
PT Evaluation Coding
 
Section GG
 
PROFESSIONAL KNOWLEDGE AND SKILLS
1 2 3 4
 
Concurrent Therapy
 
Group Therapy
 
Infection Prevention
 
Interdisciplinary Case Management/Case Management
 
Pain Assessment & Management
 
Screening/Adding Caseload
 
Supervisory/Management Experience
 
Age Specific
1 2 3 4
 
Neonate/Infant
 
Toddler/Preschool
 
School Age Children
 
Adolescents
 
Young/Middle Adults
 
Older Adults/Geriatrics
 
CERTIFICATIONS AND QUALIFICATIONS (Current at time of completing this form)
 
APTA Specialty
 
"BIG" Certification
 
BLS
 
Lymphedema Management
 
NDT
 
Non Violent Crisis Intervention (e.g. CPI)
 
Other (specify)
PT/PTA Skills Checklist, version 8

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. Falsification of any information provided, will result in being ineligible to travel with AMN. 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.

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