Dialysis Tech Skills Checklist

Personal Information

Please fill the Recruiter Email correctly for successful application submission.

Candidate Name

Email of Recruiter / POC

Select Submission Date

SSN (Last 4 digits)

Proficiency Scale & Legend

1 No experience

2 Need Training

3 Able to perform with supervision

4 Able to perform independently

Experience

Set Up / Initiate Dialysis Treatment

Assess Patient And Equipment During Dialysis

Machine Alarm Troubleshooting Procedures

Discontinue Dialysis

Care Of Patient With

Age Specific Skills

I have filled out this skills checklist to the best of my knowledge and agree that all the information provided is correct, and that any misrepresentation or falsification of fact may be considered sufficient cause for immediate dismissal from the agency.