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Santa Cruz County Personnel Department

Supplemental Questionnaire

Last Name First Name



The supplemental questions are designed specifically for this recruitment. Applications received without the required supplemental information will be screened out of the selection process. Employment experiences referred to in your responses must also be included in the Employment History section of the application.

NOTE: Please answer the questions below as completely and thoroughly as possible, as your answers may be used to assess your qualifications for movement to the next step in the recruitment process.


Describe your experience with planning, assigning, and scheduling nursing and provider support staff duties (e.g. Medical Assistants). Please include how many staff members you were responsible for.


Please describe your experience assessing patients. For example, how would you determine the need for immediate treatment versus scheduling an appointment.


Please submit any required certification(s) in one of the following ways:

Upload online with your application (OTHER Tab)
fax: 831-454-2411
hand deliver or mail: 701 Ocean Street, Room 510, Santa Cruz, CA 95060