Potential Strike
Multistate
submit request
Clinical Lab Scientist (CLS) - ALLIED
Requirements
:
California Clinical Lab Scientist license
-- please complete this form honestly and accurately --
First Name
*
Last Name
*
Email
*
Phone
*
Do you have a California Clinical Lab Scientist license?
*
No
Yes
Do you have BLS certification?
*
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?
*
No
Yes
Can you work a Mid shift?
*
No
Yes
Can you work a Night shift?
*
No
Yes
What is your Primary Shift preference?
*
Day
Mid
Night
100% Flexible
How many years experience do you have as a Clinical Laboratory Scientist?
*
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
What Facility and City, State have you worked as a Clinical Laboratory Scientist at most recently?
*
Do you have Hematology experience?
*
No
Yes
Do you have experience with Urinalysis?
*
No
Yes
Do you have Biochemistry experience?
*
No
Yes
Do you have Blood Bank experience?
*
No
Yes
Do you have Bacteriology experience?
*
No
Yes
Can you effectively present information one-on-one or in small group settings?
*
No
Yes
Can you write simple correspondence and memoranda?
*
No
Yes
List any specific areas of the Laboratory in which you are NOT COMFORTABLE working independently:
*
Please supply an Emergency Contact name and phone number:
*
