**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**
1
Describe your professional experience in health services. Health services is defined as experience in areas other than Mental Health, Developmental Disabilities or Addictions.
Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application. If you do not possess experience in this area, put N/A in the box below.
2
Describe your professional experience with partner services and/or disease intervention.
This experience should be included on your application. If you do not possess this type of experience, please put N/A in the text box.
3
Describe your professional experience with STI/HIV prevention.
This experience should be included on your application. If you do not possess this type of experience, please put N/A in the text box.
4
Describe your experience working with the LGBTQIA community, unstably housed populations, adolescents, persons with criminal justice involvement, and/or persons actively engaging in substance use.
This experience should be included on your application. If you do not possess this type of experience, please put N/A in the text box.
5
Describe your experience with communicable diseases.
Include name of employer, job title, dates of employment, and hours worked per week for each relevant position. This experience must be reflected in your application. If you do not have this experience, put N/A in the box below.
6
Describe your knowledge of and/or experience with public health surveillance databases (i.e., NEDSS, STI/HIV NBS, MAVEN, PRISM, Salesforce).
This experience should be included on your application. If you do not possess this type of experience, please put N/A in the text box.
7
Do you possess certification in Phlebotomy? If you respond YES to this question, please upload a copy of your certification to this application.
Yes
No
8
If you are not actively certified in and practicing phlebotomy, would you be willing to become certified and perform field phlebotomy?
Yes
No
9
This position requires travel throughout the State of Maryland. Are you willing to meet this requirement?
Department of Budget and Management