Official SealSan Joaquin County Human Resources Division

Supplemental Questionnaire

Last Name
First Name

This is a departmental promotional recruitment for San Joaquin General Hospital. Qualified applicants must currently be a San Joaquin County employee who is employed with San Joaquin General Hospital.


Are you a current County employee working at San Joaquin General Hospital?
Yes No

Please complete the following supplemental questions for the position of Dialysis Patient Care Technician. This supplemental will be utilized to best determine your qualifications for this position.



Have you completed a Hemodialysis Training Program that has been approved by the State of California? (Note, if yes, please be sure to clearly identify this information on your employment application under education or on your resume)

Yes No

Professional Certification:

Are you currently Certified as a Hemodialysis Technician (CHT) by the State of California?

Yes No


Please acknowledge that you understand this position will require employees to work rotating shifts.

I understand that this position will require that I am available to work rotating shifts.