Careers

Personal Info

Contact

E-mail (leave blank if no e-mail)

Acute, Radiology, Rad/Onc, ER, Clinic or Pathology

Days/ Hours Available to Work:

No Preference
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

EDUCATION AND OTHER INFORMATION

TYPE OF SCHOOL
NAME OF SCHOOL
LOCATION (Complete mailing address)
YRS. COMPLETED
MAJOR & DEGREE
High School
College
Bus. or Trade School
Professional School

Please list two emergency contacts

Please list two professional references other than a relative

An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to add any additional information necessary to describe your full qualifications for the specific position for which you are applying.

MILITARY

Work Experience

Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name. DO NOT PUT SEE RESUME! COMPLETELY FILL OUT THE ENTIRE WORK EXPERIENCE SECTION BELOW.

Job One

Employment Dates

Salary

Number of lines transcribed per hour/day

Job Two

Employment Dates

Salary

Number of lines transcribed per hour/day

Job Three

Employment Dates

Salary

Number of lines transcribed per hour/day

Your Experience Profile

Please list your years of experience in each area:

Use this rating system for the following questions

1. No Experience
2. Need Improvement
3. Average
4. Very Good
5. Excellent

Please rate your experience level

H&P
Clinic/Progress Notes
Consult
OP
Cardiac Cath
DS
ER
Radiology
Pathology
Cardiology (EKG, ECHO, Holter)
Neurodiagnostic Studies (EMG, EEG, nerve

Are you proficient with accents?

Asian
Middle Eastern
Hispanic
Indian
Fast Dictators

What is your proficiency for each specialty?

GI/GU
Otolaryngology
General Surgery
Cardiology
Ophthalmology
Neurology
Pulmonology
Dermatology
Neurosurgery
Family Medicine
Allergy/Immunology
Plastic Surgery
Internal Medicine
Infectious Disease
Oncology
Orthopedics
Hematology
OB/GYN
Podiatry
Radiology/Oncology
Psychiatry
Pain Mgmt/Anesth
Pediatrics