Official SealSan Joaquin County Human Resources Division


#0918-RH4930-01
Supplemental Questionnaire

Last Name
First Name
1.

This position requires completion of an acceptable Histology Technician training program.  (This may be either an approved academic program or acceptable on-the-job training).

In the space provided below, list the Histological Technician training program you completed. 

2.

Do you possess six months as a Laboratory Assistant or similar classification, which included on-the-job training in the performance of Medical Technician duties?

Yes No
 

If yes, please identify the following:

  • Job Title
  • Duties performed
  • Date of employment
  • Name of employer (hospital, doctor's office or medical clinic)
  • Hours worked per week