Official SealSan Joaquin County Human Resources Division


#0922-RH0200-TM
Supplemental Questionnaire

Last Name
First Name
1

This position requires at least two (2) years of full-time (40 hours per week; 2080 hours worked per year) paid general office clerical work, one (1) year of which included gathering personal and financial information from patients and/or families. 

The experience must have been in one of the following:  physician's office, medical clinic, or acute care hospital.  If you possess this experience, please indicate which of the facilities you are/were employed:
Physician's office
Medical clinic
Acute care hospital
All of the above
None of the above
2

SUBSTITUTION

One year of business training in an approved school or training program may be substituted for six months of general clerical experience.

Have you completed a one year business training in an approved school or training program?
Yes No
2a

If yes, please provide the following:

  • name of program/school
  • certificate/degree received