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.

Describe your experience in an outpatient clinical setting.

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

Describe your experience working with culturally diverse populations.

I understand that I must submit a copy of the following by the final filing deadline:

• Proof of the required Associate's Degree in Nursing or diploma in Nursing from a three year RN program. All applicants must submit a copy of their degree (verifying the degree, date earned and area of specialization) or transcripts (official/unofficial verifying the student, institution, and date and degree conferred).
• Verification of Registered Nurse license issued by the California State Board of Registered Nursing

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