Surgical 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; Theory/observed only

2 Intermittent experience; < 5 times per year; Needs review

3 Moderate experience; > 5 times per year; May need minimal resource

4 Competent; Performs on a daily or weekly basis; Proficient

Trauma Surgery

Transplant Surgery

Organ Procurement (Harvest)

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.

Surgical Tech Skills Checklist

Personal Information

Proficiency Scale & Legend

General Surgery

E.n.t.

Cardiac / Thoracic / Vascular

Vascular Surgery

Orthopedics

Urology

Gynecology

Neurology

Trauma Surgery

Plastics