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Hudson Staffing Travel Nurses| Occupational Therapist Online Checklist
Occupational Therapist Online Checklist
Thank you for your decision to apply for a travel nursing position with
! Before we can offer you a nursing employment opportunity in the Occupational Therapist 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.
Denotes a required field.
Please enter your full name as it appears on your Social Security Card:
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:
Confirm E-mail Address
Type your e-mail address again above.
This profile is for use by healthcare professionals in the Occupational Therapist discipline and specialty.
It will not be a determining factor for the program.
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
Total Hip Replacements
Total Knee Replacements
UE Joint Replacements
Trauma Hand Injury
General Acute Care
Traumatic Brain Injury
Spinal Cord Injury
Peripheral Nerve Injury
Reflex Sympathetic Dystrophy
Cumulative Trauma Disorders
Gullian Barre Syndrome
Juvenile Rheumatoid Arthritis
Peravise Developmental Disorders
General Medical Conditions
Serial Inhibitory Casting
UE Prosthetics Assess/Train
LE Prosthetics Assess/Train
Y/N Modality Certification
Y/N Certified Hand Therapist
Independent Living Skills/Life Management Skills
Work Simplification/Energy Conservation
700 & 701 Forms
General Acute Care
Skilled Nursing Facility
Home Health Care
Industrial Medical Clinic
CHT-Certified Hand Therapist
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 Occupational Therapist Skills Checklist to the client facilities in relation to consideration of employment as a healthcare professional with those facilities.
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 (220.127.116.11) which will be used as a digital signature.
Your resource for traveling nurse and allied health career opportunities.
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