California - Potential Strike
Submit Request
CNA - Certified Nursing Assistant /Patient Care Tech
Requirements
:
California CNA registration
BLS
-- please complete this submission form honestly and accurately --
First Name
*
Last Name
*
Email
*
Phone
*
Are you a registered CNA in California?
*
No
Yes
What is your California CNA registry number?
*
Do you have BLS certification?
*
No
Yes
What specialties do you float to?
*
Do you have the COVID Vaccination?
*
No
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 CNA-Patient Care Tech?
*
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 CNA-Patient Care Tech in the past year?
*
No
Yes
At what facility have you worked as a CNA-Patient Care Tech most recently?
*
How much experience do you have in a hospital setting?
*
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 in any other settings or modalities?
*
No
Yes
If so, how long and what type of setting or modality?
Would you be comfortable in a Rehab unit?
*
No
Yes
What other units are you comfortable working in?
*
Can you perform EKGs?
*
No
Yes
Can you draw labs?
*
No
Yes
Do you have 1:1 experience with disoriented or suicidal patients?
*
No
Yes
List any other skills or duties you can perform:
*
