NW - Potential Strike
Submit Request
CT Tech - ALLIED
Requirements
:
BLS
ARRT (CT)
Oregon or Washington Diagnostic Radiologic Technologist License
-- please complete this form honestly and accurately --
First Name
*
Last Name
*
Email
*
Phone
*
Do you have BLS certification?
*
No
Yes
Do you have ARRT certification?
*
No
Yes
What is your ARRT certification #?
*
Do you have a Oregon or Washington Certified RT License?
*
No
Yes
What is your Oregon or Washington Certified RT License #?
*
Are you certified for Fluoroscopy?
*
No
Yes
Are you certified for venipuncture?
*
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 CT Tech experience do you have?
*
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 CT Tech in the past year?
*
No
Yes
What Facility and City, state have you worked as a CT Tech most recently?
*
How many years experience do you have performing general CT?
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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
How many years experience do you have performing PET scans?
*
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 equipment do you have experience with?
*
Have you used a portable CT? (Body TOM)
*
No
Yes
Can you start an IV?
*
No
Yes
Can you work in CT angio?
*
No
Yes
Do you have trauma experience?
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No
Yes
How much experience do you have with 3D reconstruction?
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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
Do you do contrast injections?
*
No
Yes
Can you perform sedation?
*
No
Yes
Do you work with Pediatrics?
*
No
Yes
Please supply an Emergency Contact name and phone number:
*
