RESPIRATORY THERAPIST SKILLS CHECKLIST
This profile is for use by Respiratory Therapists with more than one year experience in their discipline and specialty. It will not be a determining factor for the Advantage RN program.
Please enter your full legal name as it appears on your Social Security Card.
First Name: Last Name: email :
Please check the boxes below for each age roup for which you have provided age-appropriate care:
Please indicate your level of experience: A. Theory, no practice B. Intermittent C. One-Two Years Current Experience D. Two-plus years experience, can function independently
The information I have given is true and accurate to the best of my knowledge. I hereby authorize Advantage RN to release this Respiratory Checklist to facilities of Advantage RN in relation to consideration of my employment.