CMA Skills Checklist

Skills Checklist

Let’s assess your clinical skills and experience. Fill out this checklist to get one step closer to your next opportunity.

1

= No theory and/or experience
2

= Limited Experience
3

= Experienced/minimal support needed to perform
4

= Proficient

Age of Patients Cared For
Newborn/Neonate (Birth to 30 days)*
- 1
- 2
- 3
- 4
Infant (1 month to 1 year)*
- 1
- 2
- 3
- 4
Toddler (1 year to 3 years)*
- 1
- 2
- 3
- 4
Preschooler (3 years to 5 years)*
- 1
- 2
- 3
- 4
School Age (5 years to 12 years)*
- 1
- 2
- 3
- 4
Adolescents (12 years to 18 years)*
- 1
- 2
- 3
- 4
Young Adults (18 years to 39 years)*
- 1
- 2
- 3
- 4
Middle Adults (39 years to 64 years)*
- 1
- 2
- 3
- 4
Older Adults (64 years to 79 years)*
- 1
- 2
- 3
- 4
Elderly Adults (79 years and up)*
- 1
- 2
- 3
- 4
Skills
Taking and Recording Ht. And Wt.*
- 1
- 2
- 3
- 4
Recording of History*
- 1
- 2
- 3
- 4
Blood Pressure*
- 1
- 2
- 3
- 4
TPR*
- 1
- 2
- 3
- 4
Recording Vital Signs*
- 1
- 2
- 3
- 4
Blood collection by venipuncture/phlebotomy*
- 1
- 2
- 3
- 4
Blood collection by capillary stick*
- 1
- 2
- 3
- 4
Knowledge of colors of test tube*
- 1
- 2
- 3
- 4
Urine collection/urinalysis*
- 1
- 2
- 3
- 4
Specimen handling and labeling*
- 1
- 2
- 3
- 4
Ability to perform EKG*
- 1
- 2
- 3
- 4
Injection:*
- 1
- 2
- 3
- 4
Intramuscular*
- 1
- 2
- 3
- 4
Subcutaneous*
- 1
- 2
- 3
- 4
Intradermal*
- 1
- 2
- 3
- 4
Wound dressing and changing*
- 1
- 2
- 3
- 4
Sterile technique*
- 1
- 2
- 3
- 4
Assisting in biopsies*
- 1
- 2
- 3
- 4
Assisting in suture or staple removal*
- 1
- 2
- 3
- 4
Knowledge of Universal Precaution*
- 1
- 2
- 3
- 4
Assisting in telephone triage*
- 1
- 2
- 3
- 4
Assisting in clerical duty*
- 1
- 2
- 3
- 4
Physician Practice
Cosmetic Surgery*
- 1
- 2
- 3
- 4
Dermatology*
- 1
- 2
- 3
- 4
Family practice*
- 1
- 2
- 3
- 4
Internal medicine*
- 1
- 2
- 3
- 4
Geriatrics*
- 1
- 2
- 3
- 4
OB-GYN*
- 1
- 2
- 3
- 4
Oncology*
- 1
- 2
- 3
- 4
Ophthalmology/Optometrist*
- 1
- 2
- 3
- 4
Orthopedic*
- 1
- 2
- 3
- 4
Pediatrics*
- 1
- 2
- 3
- 4
Psychiatry*
- 1
- 2
- 3
- 4
Urology*
- 1
- 2
- 3
- 4
Please list the EMR systems you have used*
*
I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form.*
*
I hereby consent to allow CrossMed Healthcare Staffing Solutions to release these skills checklist to the client facilities.*
Your Recruiter*
Name*
First Last
Email*
Phone*
TODAY'S DATE*
MM slash DD slash YYYY

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Skills Checklist

Age of Patients Cared For

Skills

Physician Practice