Official SealSan Joaquin County Human Resources Division


#0922-RH6205-01
Supplemental Questionnaire

Last Name
First Name
1.

This position requires candidates to possess and maintain a current license as a Physical Therapist by the Physical Therapy Board of California (PTBOC).

Please provide the license number below:

2.

Pattern I

Do you possess three years of progressively responsible experience as a licensed physical 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 physical therapist performing diagnostic and therapeutic physical 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.