Official SealSan Joaquin County Human Resources Division


#0222-RH3200-TM
Supplemental Questionnaire

Last Name
First Name
1.

Have you successfully completed a Medical Assistant program of training in an approved college or business school?  Note:  A copy of completion of the training program must be submitted with employment application in order to be considered.  You may attach a copy of your certificate to your online application.
Yes No
 

If yes, please specify:

  • name of program/school:
  • date of program completion: 
  • date certificate/degree received:
2.

This recruitment may be utilized to fill Outpatient Clinic Assistant positions that must have the ability to work 10 hour shifts which may include weekends and evenings. 
Yes, I acknowledge and accept that the position may require 10 hour shifts which including weekends and evenings.
No, I'm unable to work 10 hour shifts which may include weekends and evenings.
3.

This recruitment may be utilized to fill part time and temporary Outpatient Clinic Assistant vacancies. 

Please indicate your preference of referral below, if any:
Yes, I am interested in part time positions
Yes, I am interested in temporary positions
4.

This recruitment may be utilized to fill vacancies within the Special Care Clinic. This clinic provides care to an inmate patient population. Please indicate below if you want to be considered for referral to the Special Care Clinic.
Yes, please consider me for positions in the Special Care Clinic.
No, I am not interested in being referred to the Special Care Clinic.