Potential Strike
Multistate
submit request
Cath Lab/EP Tech - ALLIED
Requirements
:
BLS
either RCES or RCIS certification --OR--
ARRT + CRT certification
California Fluoroscopy permit (preferred)
-- please complete this form honestly and accurately --
First Name
*
Last Name
*
Email
*
Phone
*
Do you have BLS certification?
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No
Yes
What is your Radiologic Tech certification?
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ARRT
ARRT-CI (cardiac intervention)
ARRT-VI (vascular intervention)
RCES (cardiovascular electrophysiology specialist)
RCIS (cardiovascular invasive specialist)
not certified
Do you have a Radiologic Tech certification issued by the state of California?
*
No
Yes
Do you have a Fluoroscopy certification issued by the state of California?
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No
Yes
Do you have a Venipuncture certification issued by the state of California?
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No
Yes
List any other certification you have:
*
What specialties do you float to?
*
Do you have the COVID Vaccination?
*
No - Requesting Exemption
Yes - Vaccinated
Yes - Vaccinated with Booster
Typically for strike assignments: 5x12/hr shifts (60/hrs week) Are you ok with this?
*
No
Yes
Can you work a Day shift?
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No
Yes
Can you work a Mid shift?
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No
Yes
Can you work a Night shift?
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No
Yes
What is your Primary Shift preference?
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Day
Mid
Night
100% Flexible
How many years Cath/EP Lab experience do you have?
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None
6 Months or less
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
More than 10 Years
Have you worked as a Cath/EP Lab Tech in the past year?
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No
Yes
What Facility, city and state, have you worked as a Cath/EP Lab Tech most recently?
*
How much hospital experience do you have?
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None
6 Months or less
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
More than 10 Years
Which hospital units are you most comfortable working?
*
How much outpatient experience do you have?
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None
6 Months or less
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
More than 10 Years
In which other modalities have you worked, if any, and for how long?
Can you scrub Cath and EP cases?
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No
Yes
What age patients are you comfortable caring for?
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Do you have experience with neonatal patients?
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No
Yes
Can you run fluoroscopy?
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No
Yes
If yes, in which department did you run fluoroscopy?
Can you conduct cardiac stress tests?
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No
Yes
Have you worked in trauma?
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No
Yes
Do you have experience with CABG?
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No
Yes
How many open hearts have you assisted with this past year?
*
Do you have experience with PEDS open heart?
No
Yes
Do you have experience with heart and lung transplant?
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No
Yes
Can you deploy closure devices?
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No
Yes
Do you use IVUs?
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No
Yes
Can you operate radiologic, fluoroscopic, and laser equipment for patient imaging?
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No
Yes
Can you inject contrast?
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No
Yes
Can you operate EKG equipment?
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No
Yes
Which equipment brands do you have experience with?
*
Please supply an Emergency Contact name and phone number:
*