Do you possess three years of progressively responsible experience as a licensed physical therapist in San Joaquin County?
Yes
No
If you answered yes to the above question, identify the following:
Dates of employment
Job title
Average hours worked per week
Job duties
2.
PATTERN II
Do you possess four years of progressively responsible experience as a licensed physical therapist performing diagnostic therapy techniques for a variety of disabling conditions?
Yes
No
If you answered yes to the above question, identify the following:
Dates of employment
Name of employer
Job title
Average hours worked per week
Job duties
3.
Licenses and Certifications:
Do you possess a current license as a Physical Therapist issued by the Physical Therapy Board of California?
Yes
No
If you answered yes to the above question, provide the following: