Official SealSan Joaquin County Human Resources Division


#0121-RH2001-TM
Supplemental Questionnaire

Last Name
First Name
1.

Possession of a valid license as a Vocational Nurse issued by the State of California, Board of Vocational Nurse and Psychiatric Technician Examiners; or possession of a valid interim Permit issued by the Board is required.

Check mark below what you possess:

I possess a valid Vocational Nurse License.
I possess a valid Vocational Nurse Interim Permit.
I do not possess a valid Vocational Nurse License or Interim Permit.
 

Please provide your license number or interim permit number below:

2.

Please identify the department(s) below which you would be interested in being referred to. (Check ALL that apply). Vacancies may not currently exist in all units.

Emergency Department
Family Maternity Center, Labor and Delivery
Post-Partum, Pediatrics
Float Pool Unit
Hemodialysis Unit
Intensive Care Nursery (ICN)
Intensive Care Unit (ICU)
*Medical Guarded Unit (Please note: must successfully pass CDCR background investigation)
Medical Surgical Unit
*Perioperative Services (Surgery/Recovery - Please note: must be able to report to work within 30 minutes of call)
Progressive Care Unit (PCU)