Nurses
PayCruit Logo

Physical Therapist And Physical Therapy Assistant Skills Checklist

Candidate Self Assessment

Personal Information

Please fill the Recruiter Email correctly for successful application submission.

EXPERIENCE AND SKILLS LEVEL:\r\nPlease use the key below for the remainder of this checklist. Check the appropriate box that best describes your skill level in each of the following categories:

Proficiency Scale & Legend

1 No Experience
2 Clinical Experience Only
3 Intermittent/Previous Experience Teach
4 Less than 2 Years of Experience
5 2+ Years of Experience
6 10+ Years of Experience / Can

Age Specific Practice:

1
2
3
4
5
6

Modalities/ Treatment Techniques/ Assessments/ Evaluations

1
2
3
4
5
6

General Experience > Neurological

1
2
3
4
5
6

General Experience > Orthopedic

1
2
3
4
5
6

General Experience > Specialties

1
2
3
4
5
6

General Experience > Other

1
2
3
4
5
6

Pediatrics

1
2
3
4
5
6

Pediatric Assessments/ Evaluations/ Techniques:

1
2
3
4
5
6

GENERAL WORK SETTING EXPERIENCE:

Please indicate how many years/months of professional work experience you have in each of the following settings. If you do not have any work experience in a category please indicate “0”. Write “C” next to number if experience was solely during your clinical/internship.

Work Setting Length of Time (in years)
Hospital-General Acute
Hospital-Trauma Acute
Hospital-Sub-Acute
Hospital-Inpatient Rehab
Hospital-Outpatient Neuro
Hospital-Outpatient Ortho
Outpatient-Sports Medicine
NICU
Peds-Inpatient
Peds-Outpatient
Peds-Outpatient Developmental
Early Intervention
Head Start Program
Schools (K-12)
Day Rehab
Home Health - Adults
Home Health - Peds
Industrial Rehab
Workers’ Comp
Fitness Center
Professional Sports
University/College
Research
Long Term Acute Care
Group Homes
Skilled Nursing Facility
Assisted Living
Community Program

Please list any additional skills/training/equipment: