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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


Radiation Therapist/Dosimetrist 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*
E-Mail Address* Phone Number*
 
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
 
WORK SETTINGS
1 2 3 4
 
Acute Care - Adult
 
Acute Care - Pediatric
 
Outpatient - Adult
 
Outpatient - Pediatric
 
Other (Specify)
 
PRETREATMENT
1 2 3 4
 
CT/iCT
 
MR
 
PET Scan
 
Simulation of Treatment Sites
 
Tumor Localization
 
BEAM MODIFYING/POSITIONING
1 2 3 4
 
3D Conformal Therapy
 
Block Cutting
 
B-Mode Acquisition Targeting
 
Compensation Filters
 
Custom Molds
 
Custom Shields
 
Dynamic Wedges
 
Physical Wedges
 
Portal Cast
 
TREATMENT PLANS
1 2 3 4
 
Design Treatment Plans
 
Calculate Dose of Radiation
 
Quality Assurance
 
Supervise Implementation
 
TREATMENT
1 2 3 4
 
Beam Data Acquisition for Small Fields
 
Electron Arc Therapy
 
External Beam Therapy
 
Gamma Knife
 
IGRT - Image Guided Radiation Therapy
 
IMRT - Intensity Modulated Radiotherapy
 
IORT - Intraoperative Radiation Therapy
 
Linear Accelerator
 
MiMiC - Multileaf Intensity Modulating Collimator
 
Multileaf/Dynamic Multileaf Collimator
 
Port Films/Electronic Portal Imaging
 
Respiratory Gating
 
Stereotactic Radiosurgery
 
Stereotactic Radiotherapy
 
Strontium 90 Treatment
 
Superficial Tx - Orthovoltage Radiation Treatment
 
Tomo Therapy
 
Total Body Irradiation
 
TSI - Total Skin Irradiation
 
INTERNAL TREATMENT
1 2 3 4
 
Hyperthermia
 
Microwave
 
Ultrasound - Guided
 
BRACHYTHERAPY
1 2 3 4
 
Assist with Intracavity/Interstitial Administration
 
Compute Dose Distribution
 
TREATMENT PLANNING SYSTEMS
1 2 3 4
 
Eclipse (Varian)
 
Pinnacle (Philips)
 
XiO Focus
 
Other (Specify):
 
Other (Specify):
 
RECORD & VERIFY SYSTEMS
1 2 3 4
 
Impac MOSAIQ
 
Varis-Vision/Aria
 
Other (Specify):
 
TREATMENT UNITS
1 2 3 4
 
GE
 
Philips
 
Siemens
 
Varian
 
Other (Specify):
 
Other (Specify):
 
PROFESSIONAL KNOWLEDGE & SKILLS
1 2 3 4
 
National Patient Safety Goals
 
AGE SPECIFIC/POPULATION-BASED CARE
1 2 3 4
 
Neonate/Infant
 
Toddler/Preschool
 
School Age
 
Adolescents
 
Young/Middle Adults
 
Older Adults/Geriatrics
 
EMR
 
Allscripts
 
GE
 
Bar Coding for Medication Administration
 
Cerner
 
Computer Physician Order Entry
 
Eclipsys
 
Epic
 
McKesson
 
Meditech
 
Other: Specify
 
Other: Specify
 
EMR Conversion
 
CERTIFICATIONS* (Current at time of completing this form)
 
BLS
 
ARRT (T)
 
Certified Medical Dosimetrist (CMD)
 
Other: Specify
Radiation Therapist/Dosimetrist Skills Checklist, version 5

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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