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#0122-RC2070-AC
Supplemental Questionnaire

Last Name
First Name
1.

Indicate the highest education level obtained:

Master's degree from an accredited college or university with major coursework in business administration, health care administration, economics, materials management, business analytics, or a closely related field.
Bachelor's degree from an accredited college or university with major coursework in business administration, health care administration, economics, materials management, business analytics, or closely related field.
Associate's degree from an accredited college or university with major coursework in business administration, health care administration, economics, materials management, business analytics, or closely related field.
I do not possess completion of any of the above.
2.

Do you possess current designation as a Certified Materials and Resource Professional (CMRP) by the American Hospital Association?

Yes No
3.

Describe your professional work experience directly related to acute care hospital materials management in each of the following areas.  Please clearly define your roles and responsibilities under each area.

  • Purchasing
  • Contracting
  • Negotiating
  • Inventory Control
  • Systems Management
4.

Describe your experience as a supervisor.  Include in your answer the number of staff supervised and types of positions you supervised.  What was your role and scope of responsibilities?