X-Ray Tech – Superbeo Healthcare

X-Ray Tech Skills Checklist

One program to handle all talent management needs from acquisition to development

Personal Information

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Overall Score

Out of 4

Name(Required)

First Middle Last

Last 4 Digits of Social Security Number

Email(Required)

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Date

Proficiency Scale

1 – No Experience
2 – Need Training
3 – Able to perform with supervision
4 – Able to perform independently

AGE OF PATIENTS CARED FOR

Newborn/Neonate (birth to 30 days)(Required)

Infant (1 month to 1 year)(Required)

Toddler (1 year to 3 years)(Required)

Preschooler (3 years to 5 years)(Required)

School Age Child (5 years to 12 years)(Required)

Adolescents (12 years to 18 years)(Required)

Young Adults (18 years to 39 years)(Required)

Middle Adults (39 years to 64 years)(Required)

Older Adults (64+ years)(Required)

Elderly Adults (Over 79+ years)(Required)

GENERAL SKILLS

Standard Precautions(Required)

Isolation Precautions(Required)

Pediatric Respiratory/ Cardiac Arrest(Required)

Adult Respiratory/ Cardiac Arrest(Required)

WORK SETTING

Adult Acute Care(Required)

Adult Outpatient(Required)

Pediatric Acute Care(Required)

Pediatric Outpatient(Required)

Bedside/ Portable Procedures(Required)

ER/ Trauma(Required)

OR(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)

FLUOROSCOPY 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)

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)

Authorizations

Legal Consent(Required)

I agree to the terms and conditions.

Consumer Disclosure Regarding Conducting Business Electronically, Signing Documents Electronically, and Receiving Electronic Notices and Disclosures

Please read the information below, carefully, as it concerns your rights. eSignatures are an efficient way to execute an agreement with the same legal force and effect of a handwritten or “wet ink” signature. By signing this document you are agreeing that you have reviewed this Consumer Disclosure and consent and intend to transact business electronically; to use electronic signatures instead of wet ink signatures and paper documents, and to receive notices and disclosures electronically.

You are not required to sign documents electronically or to receive notices and disclosures electronically. If you prefer not to transact business electronically, you may request paper copies from the “sending party” and withdraw your consent at any time, as described below.

Scope of Consent
By utilizing this Service, you agree to receive electronic signature documents with all related and identified documents, notices, and disclosures provided during your relationship with the “sending party.” You may withdraw your consent, at any time, by following the procedures outlined below.

Paper Copies
You are not required to sign documents electronically, or receive notices or disclosures electronically, and may request paper copies of documents or disclosures, if you prefer. You also have the ability to download and print any signed or unsigned documents sent to you through the electronic signature service. We may also email you a copy of all documents you sign using the electronic signature service. If you wish to receive paper copies instead of electronic documents you may close this web browser and request paper copies from the “sending party” by following the procedures outlined below. The “sending party” may apply a charge for additional expenses incurred by printing and mailing paper copies.

Withdrawal of Consent
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Withdrawing your consent, requesting a paper copy, or updating your contact information
You always have the ability to download and print any documents sent to you through our electronic signature system. To withdraw your consent to conduct business electronically, sign documents electronically, and receive documents, notices, or disclosures electronically, please contact the “sending party” directly; by telephone, by email (sent to the “sending party” with any of the topics outlined below stated in the subject line of your email) or by postal mail to their mailing address specified to receive such notices.

“Withdrawal of Consent To Transact Business Electronically” To allow the “sending party” to identify and facilitate your withdrawal of consent to transact business electronically, please provide your name, email address, the date on which you are withdrawing your consent, your telephone number and mailing address.

“Requesting A Paper Copy” To allow the “sending party” to identify you to provide a paper copy of the document requiring your signature, the notice, or disclosure, please provide the sending party with your name, email address, mailing address, telephone number, and name of the document of which you are requesting a paper copy .

“Update Your Contact Information” To allow the “sending party” to identify you in order to update your contact information, please provide them with your name, email address, mailing address, and telephone number.

The “sending party” will inform you of any fees related to costs for printing and mailing paper copies or your withdrawal consent to transact business electronically.

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