This Supplemental Questionnaire will be used to determine applicants’ qualifications for this position and assess an applicant’s ability to advance 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 explain your previous experience performing supervisory duties over Medical Assistants and Clinic Registered Nurses.

Please explain your previous experience overseeing daily operations of an assigned area or program, such as, an immunization clinic, trauma system program, primary care clinic, etc.

I understand that proof of my Nursing Degree, license, and certifications must be submitted for this position.

• Associate's degree from an accredited college or university in nursing or a nursing diploma from an accredited nursing program
• Current and active Registered Nurse license issued by the California State Board of Registered Nursing
• Current Adult, Child, and Infant CPR Certificate

I will be submitting all of the above in the following manner: