Occupational Therapist Checklist

Job Skills Checklist Instructions

This self-evaluation is for assessing your experience in specific clinical areas. This self-evaluation will not be a determining factor in accepting your application to become an employee of Operis Workforce.

Please select ONE answer per line item.

0 = Not Applicable
1 = No Experience
2 = Some Experience
3 = Intermittent Experience
4 = Experienced
5 = Very Experienced

*Required field

Adult Treatment Experience

Orthopedic

Fractures* 012345
Total Joint Replacements* 012345
Osteorthritis-Frozen Shoulder* 012345
Hand Injuries* 012345
Post Operative Care* 012345
Neurologic* 012345

Neurologic

Stroke Rehabilitation* 012345
Cognitive Disorders* 012345
Head Trauma* 012345
Spinal Cord Injury* 012345
Functional Splinting* 012345
Neuromuscular Diseases* 012345
Alzheimer’s/Dementia 012345
Adaptive Equipment-Wheelchair* 012345

Prosthetics/Orthotics

Upper Extremity Prosthetics* 012345

Procedures/Treatments

Splinting–Wrist* 012345
Splinting–Hand* 012345
Splinting–Elbow* 012345
Functional-Dynamic Splinting* 012345
Adaptive Equipment* 012345
Joint Mobilization* 012345
Myofascial Release* 012345
Soft Tissue Manipulation* 012345
Iontophoresis* 012345
TENS* 012345
Hydrotherapy–Whirlpool* 012345
Sterilization Techniques* 012345
Cryotherapy* 012345
Wound Management* 012345
Debridement* 012345
Ultrasound* 012345
Phontophoresis* 012345
Cognitive Techniques* 012345
Vision Therapy* 012345
Neurodevelopmental Techniques* 012345
Adaptive Equipment Assessment* 012345
Feeding Techniques* 012345
Exercise Programs* 012345
Postural Education* 012345
Home Safety Evaluation* 012345
Community Re-entry* 012345
Group Treatment* 012345



Geriatric Treatment Experience

Skilled Nursing Documentation

Medicare A* 012345
Medicare B* 012345
State Healthcare* 012345

Other

Cardiac Rehab* 012345
ICU Procedures* 012345
CCU Procedures* 012345
SICU Procedures* 012345
Burn Management* 012345
Work Hardening–Work Site Eval* 012345
Functional Capacity Eval* 012345
Transfers* 012345
Gait Training* 012345
Muscle Energy Techniques* 012345
Activities of Daily Living* 012345



Age-Appropriate Care

Ability to adapt care to incorporate normal growth and development, adapt method and terminology of client instructions as it relates to the age and comprehension level of the client, and to ensure a safe environment - reflecting specific needs of the client and various age groups.

Age Groups

Newborn (birth-30 days)* 012345
Infant (30 days-1 year)* 012345
Toddler (1-3 years)* 012345
Preschooler (3-5 years)* 012345
School Age (5-12 years)* 012345
Adolescents (12-18 years)* 012345
Young Adults (18-39 years)* 012345
Middle Adults (39-64 years)* 012345
Older Adults (64+ years)* 012345



Application Agreement*

By filling out the information below, I certify that the information provided above accurately reflects education received and my experience in each of the clinical areas identified within the last 2 years. The information I have given is true and accurate to the best of my knowledge, and I hereby authorize Operis Workforce to release this Skills Checklist to staffing clients. Submit this skills evaluation with your initial application. To be updated annually.