Skills Checklist

Congratulations on your decision to apply for a travel nursing position with Med Travelers! Before we can offer you a nursing employment opportunity, an electronic skills assessment must be completed. From the nursing 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!


Speech Language Pathologist Skills Checklist

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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*
Last 4 of Social Security Number*
- -
E-Mail Address* Phone Number*
or
 
 
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
 
WORK SETTINGS
1 2 3 4
 
Acute Care
 
Rehabilitation Facility
 
Outpatient - Adult
 
Outpatient - Pediatric
 
Children's Hospital
 
Home Health Care
 
Skilled Nursing Care
 
Long Term Acute Care (LTAC)
 
School
 
Psychiatric
 
EVALUATION
1 2 3 4
 
ALPS (Aphasia Language Performance Scale)
 
Boston
 
CADL (Communication Ability for Daily Living)
 
Minnesota (Schuell)
 
PICA (Porch Index of Communication Ability)
 
Western Aphasia Battery (WAB)
 
Oral Peripheral Exam
 
Hearing Screen
 
Clinical Evaluation of Language Fundamentals (CELF)
 
Preschool Language Scale (PLS -4)
 
Rossetti Infant-Toddler Language Scale
 
Modified Barium Swallow
 
FEES (Flexible Endoscopic Evaluation of Swallowing)
 
INTERVENTIONAL APPROACHES
1 2 3 4
 
Dysphagia Management
 
Voice/Resonance Therapy
 
Phonological Process Treatment
 
Language Disorder Management
 
Cognitive Impairment Management
 
Aural Rehabilitation
 
Augmentative Communication
 
NEUROLOGIC DISORDERS
1 2 3 4
 
Amyotrophic Lateral Sclerosis (ALS)
 
Alzheimer's Disease
 
Brain Injury
 
Cognitive Impairment
 
CVA
 
Dysarthria
 
Dysphagia - General
 
Dyaphagia - Trach
 
Dysphagia - Ventilator Dependent
 
Fluency
 
Hearing Impairment
 
Parkinson's Disease
 
Voice Disorders
 
PEDIATRIC DISORDERS
1 2 3 4
 
Articulation
 
Autism
 
Brain Injury
 
Cognitive Impairment
 
Cleft Palate
 
Feeding Disorders
 
Fluency
 
Hearing Impaired
 
Language Disorders
 
TECHNOLOGY
1 2 3 4
 
Casamba (Smart)
 
Care Manager
 
Cerner
 
Epic
 
McKesson
 
Meditech
 
Rehab Optima
 
Other (fill in the blank )
 
Other (fill in the blank )
 
 
EMR Conversion
 
BILLING/DOCUMENTATION
1 2 3 4
 
RUG Levels
 
Medicare Part A
 
Medicare Part B
 
Medicaid/Medical
 
OASIS
 
PROFESSIONAL KNOWLEDGE AND SKILLS
1 2 3 4
 
Supervisory/Management Experience
 
Screening/Adding Caseload
 
National Patient Safety Goals/Core Measures
 
Age Specific/Population-Based Care
 
Infection Prevention
 
CERTIFICATIONS
 
Praxis Exam
Small calendar
Date Taken: 
 
CCC-SLP
Small calendar
Date Issued: 
 
Bilingual Ext(Lang.) 
Small calendar
Date Issued: 
 
Vital Stim
Small calendar
Date Taken: 
 
Lee Silverman Voice Treatment
Small calendar
Date Taken: 
 
BLS
Small calendar
Exp. Date: 
 
Other:Specify 
Small calendar
Exp. Date: 
 
Other:Specify 
Small calendar
Exp. Date: 
Speech Language Pathologist Skills Checklist, version 4

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 the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.