Official SealSan Joaquin County Human Resources Division


#0922-RH6005-01
Supplemental Questionnaire

Last Name
First Name
1.

Must possess and maintain a current license as an Occupational Therapist issued by the California Board of Occupational Therapy.

Provide your Occupational Therapist license number:

2.

Pattern I

Do you possess three years of progressively responsible experience as a licensed occupational therapist in San Joaquin County service?

Yes No
 

If you answered yes, please provide your job title and dates of employment with San Joaquin County.

3.

Pattern II

Do you possess four years of progressively responsible experience as a licensed occupational therapist performing diagnostic and/or therapeutic occupational therapy techniques for a variety of disabling conditions.

Yes No
 

If you answered yes, please provide the name of your employer, your job title and dates of employment.

 

Provide a detailed description of your primary job duties.