MEDICAL LAB SKILL EVALUATION
MEDICAL LAB SKILL EVALUATION
Personal Information
Name
*
First
Last
Title / Specialty
*
Email
*
Phone
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Hematology
CBC
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Differential
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Reticulocyte Count
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Platelet Count
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Sickel Cell Prep
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Eosinophil
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Sedimentation Rate
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Blleding Time
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
PT & PTT
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Fibrinogen
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Factor Assays
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Thrombin Time
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Fibrin Split Products / FDP
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Plaele Aggregation
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Lee-White Clotting Time
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Fetal Hemoglobin
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Body Fluid Count
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Special Stains
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Serology / Immunology
RPR
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Radial Immuno Diffusion
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
FTA-ABS
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
LE Cell Prep
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
TORCH Studies
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
C3, C4 Total Complement
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Pregnancy Testing
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Rebella Serology
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Rebella Serology
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Hemagglutination Inhibition
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
ANA
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Febrile Agglutinations
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Rheumatoid Factor
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Monospot
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
ASO Titer
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Chemistry
Acetone Analysis
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Osmolality
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
CSF Protein
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Immunoelectrophoresis
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Thin Layer Chromatography
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Stool Analysis
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Fecal Fats
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Electrophoresis
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Atomic Absorption
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Gas Chromatography
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Blood Bank
Patient ID Procedures
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Cross Match
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Immediate Spin Cross Match
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Type, RH
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Antibody Titer
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Antibody Identification
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Coombs Test
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Direct
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Indirect
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Rhogram
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Donor Unit Collections
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Blood Irradation
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Plasmaphoresis
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Plateletphoresis
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Emergency Release
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Special Blood (Kell, Kidd, Duffy, RH-HR, MNS)
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Component Preparation
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Freezing Blood
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Cold Aggluntinins
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Microbiology / Virology
Gram Stain
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Acid Fast Stain (Kinyoun)
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Acid Fast Stain (Flurescent)
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
India Ink
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
West Mount-Motiliy
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Darkfield
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Darkfield
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
KOH Prep
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Culture Plating
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Organism Identification
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Sensitivities
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
K.B
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
M.I.C
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Blood Culture
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Anaerobic Culture
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Anaerobic Identification
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Ova and Parasite Identification
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Trichone
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Wet Mount
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Myobacteria
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Culture
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Concentration Techniques
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Identification
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Chlamydia Culture
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Chlamydia Smear
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Cell Colture Technique (Viral)
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Virus Isolation
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Virus Identification
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
C Difficili Assay
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Malarial Examination
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Occult Blood
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Urinalysis
Macroscopic U.A
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Crystal Indenification
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Microscopic U.A
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Semen Analysis
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
RIA
Radiation Safety Techniques
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Background Counts
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Data Reduction
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Curves / Regressions
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Hormone Testing
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
B12 Folates
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Hepatitis
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Gamma Instrumentation
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Scintillation Counter Instrumention
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Thyroid Testing
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Tumor Markers
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
General
Phlebotomy
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Venipuncture
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Pediatric
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
M.L.A
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
To Deliver
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
To Contain
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Volumetric
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Operation of Centrifuge
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Knowledge of Tube Types and Uses
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Fingerstick
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Heel Stick
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Pipetting
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Calculation for Solution Prep
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Use of Balance
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Basic Safety Guidelines
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Communication Skills w/Physicians and Nurse
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Ability to Write Procedures
Perform Well - Two plus years experience
Limited Experience - One - Two years experience
Intermittent Experience
Theory - No Practice
No Experience
Additional Information
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