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Hudson Staffing Travel Nurses| Speech Language Pathologist Online Checklist
Speech Language Pathologist Online Checklist

Thank you for your decision to apply for a travel nursing position with Hudson Staffing! Before we can offer you a nursing employment opportunity in the Speech Language Pathologist field, an electronic skills assessment must be completed. Please, complete the nursing skills checklist below, and be sure to review your information thoroughly before clicking the submit button.

GENERAL INFORMATION        
Note: * Denotes a required field.
Please enter your full name as it appears on your Social Security Card:

First Name
 
Middle Name
 
Last Name
 *


Please enter the Last Four digits of your Social Security Number:

 -   -   *       Please check here if you do not hold a valid social security card.


Please provide your contact information:

Phone Number
 *
E-mail Address
 *
Confirm E-mail Address
 *
Type your e-mail address again above.
       
This profile is for use by healthcare professionals in the Speech Language Pathologist discipline and specialty.
It will not be a determining factor for the program.
CHECKLIST INSTRUCTIONS        
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

General Skills 1 2 3 4
     Electronic Documentation
     Home Health Documentation
     Medicare Documentation
     Patient/Family Education
     Patients in Isolation
     Patients in Restraints
Assessment Tools & Treatment Techniques 1 2 3 4
     Bedside Swallow Evaluation
     Boston Assessment of Severe Aphasia
     Boston Diagnostic Aphasia Examination
     CADL (Communication Ability for Daily Living)
     Cognitive Training
     Co-Treatment with OT
     Co-Treatment with PT
     F.E.E.S. (Fiber Endoscopic Evaluation Study)
     Group
     Individual
     Minnesota Test for Differential Diagnosis of Aphasia
     Modified Barium Swallow Study
     PICA (Porch Index of Communicative Abilities)
     Pure Tone Screening
     Rehab Institute of Chicago Evaluation of Communication
     Ross Information Processing Assessment-Geriatric
     Safety Awareness
     Thermal Stimulation
     Thickening Agents
     Vital Stimulation
     Western Aphasia Battery
Adaptive Equipment 1 2 3 4
     Augmentative/Alternative
     Communication Board
     Communication Devices
     Feeding Equipment
     Memory Aide
Types of Disabilities 1 2 3 4
     Aphasia
     Apraxia
     Autism
     Cleft Palate
     Obturators
     Palatal Lifts
     Prosthetic Devices
     Dementia/Alzheimers
     Dysarthria
     Dysphagia
     Compensatory Techniques
     Laryngectomy
     Tracheotomy
     Ventilator Dependent/Assisted
     Fluency/Stuttering
     Head Injury
     Hearing Impaired
     Learning Disabilities
     Progressive Neurological Disease
     Traumatic Brain Injury
     Stroke/CVA/Rehab
Settings 1 2 3 4
     Community Re-Entry
     Day Treatment Center
     Early Intervention
     General Acute Care
     Home Health
     Inpatient Acute Rehab
     School System
     Outpatient Clinic
     Pediatric Rehab
     Private Practice
     Psychiatric
     Skilled Nursing Facility
Age 1 2 3 4
     Newborn (birth – 30 days)
     Infant (30 days – 1 year)
     Toddler (1 – 3 years)
     Preschooler (3 – 5 years)
     School Age (5 – 12 years)
     Adolescents (12 – 18 years)
     Young Adults (18 – 39 years)
     Middle Adults (39 – 64 years)
     Older Adults (64+ years)
Please read and agree to the statements below by marking the checkbox. You will not be able to submit until you have marked the checkbox.

* 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 Hudson Staffing to release this Speech Language Pathologist Skills Checklist to the client facilities in relation to consideration of employment as a healthcare professional with those facilities.




Privacy Note: Hudson Staffing will record anonymous electronic information about your connection when you click on the submit button. This information is used for security purposes only. This information will include your IP Address (44.192.65.228) which will be used as a digital signature.



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Hudson Staffing
Phone: 1(866)256-8773
E-mail: info@hudsonstaffing.net

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