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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 (18.210.22.132) which will be used as a digital signature.
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Hudson Staffing
Phone:
1(866)256-8773
E-mail:
info@hudsonstaffing.net
Your resource for traveling nurse and allied health career opportunities.
Copyright (C) 2013 Hudson Staffing. All rights reserved.
