Please rate your experience / frequency within the last year

0 = No Experience / Observed Only
1 = Limited Experience / Rarely Done (<6 times/year)
2 = May Need Some Review / Occasionally Done (1 – 2 times/month)
3 = Experienced / Frequently Done (daily or weekly)

MM slash DD slash YYYY

AGE OF CLIENTS:

Newborn/Neonate (birth to 30 days)(Required)
Infant (31 days to 12 months)(Required)
Toddler/Preschool (13 months to 5 years)(Required)
School Age Child/adolescent (6 years to 18 years)(Required)
Young Adults Middle Adult (19 years to 64 years)(Required)
Older Adults/Elderly (65+years)(Required)

GENERAL SKILLS

Standard Precautions(Required)
Isolation Precautions(Required)
Pediatric Respiratory/ Cardiac Arrest(Required)
Adult Respiratory/ Cardiac Arrest(Required)

CHEST AND THORAX

Chest Routine(Required)
Chest SP(Required)
Ribs(Required)
Chest Lateral Decubitus(Required)
Sternum(Required)
Upper Airway (Soft-Tissue Neck(Required)

UPPER EXTREMITY

Thumb or Finger(Required)
Hand(Required)
Wrist(Required)
Forearm(Required)
Elbow(Required)
Humerus(Required)
Shoulder(Required)
Trauma(Required)
Clavicle(Required)
Scapula(Required)
AC Joints(Required)

LOWER EXTREMITY

Toes(Required)
Foot(Required)
Ankle(Required)
Knee(Required)
Tibia-Fibula(Required)
Femur(Required)
Trauma(Required)
Patella(Required)
Calcaneus(Required)

HEAD

Skull(Required)
Paranasal Sinuses(Required)
Facial Bones(Required)
Orbits(Required)
Zygomatic Arches(Required)
Nasal Bones(Required)
Mandible(Required)
TMJ(Required)

SPINE AND PELVIS

Cervical Spine(Required)
Thoracic Spine(Required)
Lumbar Spine(Required)
Sacrum and / or Coccyx(Required)
Cross-Table Lateral Spine(Required)
Pelvis(Required)
Hip(Required)
Cross-Table Lateral Hip(Required)
Scoliosis Series(Required)
Sacroiliac Joints(Required)

ABDOMEN

Abdomen Supine (KUB)(Required)
Abdomen Upright(Required)
Abdomen Decubitus(Required)

FLOUROSCOPY STUDIES

Upper GI Series, Single or Double Contrast(Required)
Contrast Enema, Single or Double Contrast(Required)
Small Bowel Series(Required)
Esophagus(Required)
Cystography / Cystourethrography(Required)
ERCP(Required)
Myelography(Required)
Arthrography(Required)
Hysterosalpingography(Required)

MOBILE RADIOGRAPHIC STUDIES

Chest(Required)
Abdomen(Required)
Orthopedic(Required)

EQUIPMENT

GE(Required)
Fuji(Required)
Siemens(Required)
Toshiba(Required)
Hitachi(Required)
Portables(Required)
C-Arm(Required)

EMR

eClinicalworks(Required)
EPIC(Required)
McKesson(Required)
Care 360(Required)
Allscripts(Required)
Cerner(Required)
GE(Required)
Optum Insight(Required)
NextGen(Required)
Greenway(Required)

PACS

Ambra Health(Required)
Sectra(Required)
Infinitt(Required)
IBM Merge(Required)
McKesson(Required)
Philips(Required)
FujiFilm(Required)
Impax(Required)
Centricity(Required)
Carestream Vue(Required)
Clarity(Required)
eRad PACS(Required)
Syngo(Required)

OTHER SKILLS