NW - Potential Strike
Submit Request
Mammography Tech - ALLIED
Requirements
:
BLS
ARRT / ARRT-M
Oregon or Washington Mammography 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 / Mammography certification?
*
No
Yes
If yes, what is your ARRT certification number?
*
Do you have a Oregon or Washington Mammography 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 Mammography 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 Mammography Tech in the past year?
*
No
Yes
What Facility have you worked as a Mammography Tech most recently?
*
Are you trained to do other radiology procedures?
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Yes
No
Are you comfortable with diagnostic positioning for breast implants vs non-breast implants?
*
No
Yes
Do you understand assistance needs of patients with various medical conditions?
*
No
Yes
Are you familiar with 3D Holistic equipment?
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No
Yes
Are you familiar with Affirm equipment?
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No
Yes
What other equipment, if any, are you familiar with?
*
Do you do assist with Biopsies?
*
No
Yes
Do you give contrast for studies?
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No
Yes
Please supply an Emergency Contact name and phone number:
*