Potential Strike
Multistate
submit request
Rad Tech - Allied
Requirements
:
BLS
ARRT certification
California Radiologic Tech certification (required for California)
California Fluoroscopy certification (preferred)
-- please complete this form honestly and accurately --
First Name
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Last Name
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Email
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Phone
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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?
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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:
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What specialties do you float to?
*
Do you have the COVID Vaccination?
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No - Requesting Exemption
Yes - Vaccinated
Yes - Vaccinated with Booster
Typically for strike assignments: 5x12/hr shifts (60/hrs week) Are you ok with this?
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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 Rad Tech 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 Rad Tech in the past year?
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No
Yes
What Facility, city and state, have you worked as a Rad Tech most recently?
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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?
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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?
What age patients are you comfortable caring for?
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Do you have experience with pediatric patients?
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No
Yes
What age group do you have the most experience?
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No
Yes
Do you have experience operating EKG machines?
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No
Yes
Do you have experience with conducting Stress Tests?
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No
Yes
Can you scrub Cath and EP cases?
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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 deploy closure devices?
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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
Do you use IVUs?
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No
Yes
Do you have experience with CABGs?
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No
Yes
How many open hearts do you assist with per year?
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Do you have experience with PEDS open hearts?
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No
Yes
Do you have experience with heart/lung transplants?
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No
Yes
Can you scrub outside of CVOR?
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No
Yes
Which equipment brands do you have experience with?
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Please supply an Emergency Contact name and phone number:
*