Skills Checklist

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

Sonographer Skills Checklist

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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*
E-Mail Address*	Phone Number*

 

 

Please mark your level of experience

1. No experience; requires education, training and supervision
2. Intermittent experience; may need support or supervision
3. Proficient; consistent experience, independent
4. Expert level; can teach/supervise others

 

WORK SETTINGS

1

2

3

4

 

Hospitals

 

Clinics

 

Mobile

 

Physician Offices

 

Adult Abdominal - Limited/Complete

1

2

3

4

 

Appendix

 

Gallbladder

 

Gastrointestinal

 

Intra-operative

 

Kidney

 

Liver

 

Pancreas

 

Spleen

 

Pediatric Abdomen/Pelvis

1

2

3

4

 

Appendix

 

Gallbladder

 

Gastrointestinal

 

Intra-operative

 

Kidney

 

Liver

 

Pancreas

 

Spleen

 

SMALL PARTS

1

2

3

4

 

Breast

 

Superficial Masses

 

Testicles

 

Thyroid

 

RENAL/PELVIS

1

2

3

4

 

Adnexa/Ovaries/Uterus

 

Hernia

 

Prostate

 

Renal Artery Doppler

 

Renal/Bladder

 

OB/GYN

1

2

3

4

 

1st trimester

 

2nd trimester

 

3rd trimester

 

Fetal Anatomical Survey

 

Fetal Echo

 

Fingers/Toes

 

Inter/Intra-Orbital Measurements

 

Mid-Cerebral Artery Doppler

 

Nuchal Translucency Screen

 

Outflow tracts

 

Umbilical Cord Doppler

 

NEONATAL

1

2

3

4

 

Abdomen/Pelvis/Renal/Bladder

 

Cardiac

 

Duodenal Atresia/Intussusception

 

Head

 

Hips

 

Spine

 

PROCEDURES

1

2

3

4

 

Assist with Ovarian Cyst Aspiration

 

Assist with Sonohystogram

 

Fine Needle Aspiration/Biopsy of above

 

Paracentesis/Thoracentesis/Amniocentesis

 

Ultrasound Guided Biopsy/FNA

 

VASCULAR

1

2

3

4

 

Abdominal Vasculature

 

Arterial Graft Studies

 

Carotid

 

Lower Extremity Arterial

 

Lower Extremity Venous

 

Plethysmography for Fingers/Toes/TOS

 

Portal System/Shunt Evaluation

 

Renal Artery Duplex

 

Transcerebral Doppler

 

Upper Extremity Arterial

 

Upper Extremity Venous

 

EQUIPMENT

1

2

3

4

 

GE

 

Hitachi

 

Philips/ATL

 

Siemens

 

SonoSite

 

Other (Specify)

 

Other (Specify)

 

PROFESSIONAL KNOWLEDGE AND SKILLS

1

2

3

4

 

National Patient Safety Goals

 

Procedures on patients in ICU/ED setting

 

Procedures on patients with isolation precautions

 

Infection Prevention

 

AGE SPECIFIC/POPULATION-BASED CARE

1

2

3

4

 

Neonate/Infant

 

Toddler/Preschool

 

School Age

 

Adolescents

 

Young/Middle Adults

 

Older Adults/Geriatrics

 

EMR

1

2

3

4

 

Allscripts

 

GE

 

Bar Coding for Medication Administration

 

Cerner

 

Computer Physician Order Entry

 

Eclipsys

 

Epic

 

McKesson

 

Meditech

 

Other: Specify

 

Other: Specify

 

EMR Conversion

Yes

No

 

CERTIFICATIONS/LICENSURES/REGISTRATIONS(Current at the time of completing this form)

 

ARRT - Sonography

Yes

No

 

BLS

Yes

No

 

CCI-RVS

Yes

No

 

FMF Certificate (Specify all)

Yes

No

 

RDCS - Adult

Yes

No

 

RDCS - Fetal

Yes

No

 

RDCS - Pediatric

Yes

No

 

RDMS - Breast

Yes

No

 

RDMS - Fetal Echocardiography

Yes

No

 

RDMS - Obstetrics & Gynecology

Yes

No

 

RDMS- Abdomen

Yes

No

 

Registered Vascular Technologist

Yes

No

 

RMSKS - Musculoskeletal

Yes

No

 

Other (Specify)

 

Other (Specify)

 

Other (specify)

Sonographer Skills Checklist, version 7

You must agree with the statements at the bottom of the form before submitting your skills checklist.

Please read and agree to the statements below by marking 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. Falsification of any information provided, will result in being ineligible to travel with AMN. 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.