This Supplemental Questionnaire will be used to determine applicants’ qualifications for this position and whether they will continue in the recruitment process; therefore, applicants are encouraged to answer all questions thoroughly and completely.  Omitted information will not be considered or assumed.  Applicants who have no experience in a specific area are recommended to state "no experience in this area" instead of leaving the space blank.

Please note that the experience in your answers must be reflected in your employment history.

I understand that I am required to provide documentation of the following 'hands-on' (classroom/lab) training elements (if not included in your Medical Assistant certificate):

I have and can show proof of training in laboratory drawing of blood AND collection of other specimens.

I have and can show proof of training in ventipuncture.

I have and can show proof of training in Injection Administration.

I have and can show proof of training in performing Electrocardiograms (EKGs) and/or X-ray (CXR) procedures including chest X-rays/extremities.

Describe your experience working in areas of phlebotomy and immunizations. 

Do you possess a phlebotomy certificate?

Describe your experience with Electronic Health Records (EHR).  What systems have you used?

Describe the experience you have working with patients in Community Health Clinics; please elaborate on time spent working with individuals from lower socio-economic sectors of the community, as well as those who are undocumented, underinsured, and uninsured.

Some positions require extensive clerical, front-office or call center types of duties in addition to the medical support duties. Please tell us about your experience providing front office duties and Microsoft office software (e.g. Word, Excel) you have used.

Some positions may require bilingual skills.  Applicants who indicate bilingual skills in their application may be required to demonstrate proficiency in speaking, reading and writing in the language indicated.

Are you proficient in speaking, reading and writing any of the following languages? (select all that apply)