OB/Labor & Delivery 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 Minimal experience, need review and supervision, have performed at least once

3 Comfortable performing with resource available

4 Competent to perform independently and safely

5 Expert, able to act as resource to others

EXPERIENCE AREAS

	Years	Months
Post Partum
MB – Mother Baby
L&D – Labor and Delivery
Nursery level 1 – Well Baby
Nursery level 2 – Sick Baby
Nursery level 3 – Premature/Critically ill baby

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.

OB/Labor & Delivery Skills Checklist

Personal Information

Proficiency Scale & Legend

Patient Rights

Labor And Delivery

Labor And Delivery Procedures For The Following:

Medications

Maternity

EXPERIENCE AREAS