Physical Therapy Skills Checklist

Skills Checklist

Physical Therapist

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

Setting
Acute*
- 1
- 2
- 3
- 4
Rehab*
- 1
- 2
- 3
- 4
Inpatient*
- 1
- 2
- 3
- 4
Outpatient*
- 1
- 2
- 3
- 4
Home Health*
- 1
- 2
- 3
- 4
SNF*
- 1
- 2
- 3
- 4
Schools*
- 1
- 2
- 3
- 4
Adult Orthopedic
Neck Injuries / Surgeries*
- 1
- 2
- 3
- 4
Back Injuries / Surgeries*
- 1
- 2
- 3
- 4
Hip Fractures / Injuries*
- 1
- 2
- 3
- 4
Total Hip Replacement*
- 1
- 2
- 3
- 4
Knee Injuries*
- 1
- 2
- 3
- 4
Total Knee Replacement*
- 1
- 2
- 3
- 4
Upper Extremity Joint Replacements*
- 1
- 2
- 3
- 4
Shoulder Injuries*
- 1
- 2
- 3
- 4
Degenerative Joint Disease / Arthritis*
- 1
- 2
- 3
- 4
Hand Injuries*
- 1
- 2
- 3
- 4
Temporomandibular Joint (TMJ)*
- 1
- 2
- 3
- 4
Post Operative Care*
- 1
- 2
- 3
- 4
Amputations*
- 1
- 2
- 3
- 4
Neurologic:
Stroke Rehabilitation*
- 1
- 2
- 3
- 4
Cognitive Disorders*
- 1
- 2
- 3
- 4
Head Trauma*
- 1
- 2
- 3
- 4
Spinal Cord Injury*
- 1
- 2
- 3
- 4
Functional Splinting*
- 1
- 2
- 3
- 4
Adaptive Equipment-Wheelchair*
- 1
- 2
- 3
- 4
Neuromuscular Diseases*
- 1
- 2
- 3
- 4
Multiple Sclerosis*
- 1
- 2
- 3
- 4
Adult: Prosthetics / Orthotics:
Upper Extremity Prosthetics*
- 1
- 2
- 3
- 4
Above Knee Prosthetics*
- 1
- 2
- 3
- 4
Below Knee Prosthetics*
- 1
- 2
- 3
- 4
Sports Medicine:
LIDO Machine*
- 1
- 2
- 3
- 4
Nautilus Machine*
- 1
- 2
- 3
- 4
Taping*
- 1
- 2
- 3
- 4
Procedures / Treatments:
Ankle / Foot Orthosis*
- 1
- 2
- 3
- 4
Slings*
- 1
- 2
- 3
- 4
Splints - Wrist / Hand*
- 1
- 2
- 3
- 4
CPM Machine*
- 1
- 2
- 3
- 4
Hydrotherapy*
- 1
- 2
- 3
- 4
Whirlpool*
- 1
- 2
- 3
- 4
Myofacial Release*
- 1
- 2
- 3
- 4
Hubbard Tank*
- 1
- 2
- 3
- 4
Therapeutic Pool*
- 1
- 2
- 3
- 4
TENS*
- 1
- 2
- 3
- 4
Electrical Stimulation*
- 1
- 2
- 3
- 4
Sterilization Techniques*
- 1
- 2
- 3
- 4
Ultrasound*
- 1
- 2
- 3
- 4
Cryotherapy*
- 1
- 2
- 3
- 4
Massage*
- 1
- 2
- 3
- 4
Diathermy*
- 1
- 2
- 3
- 4
Acupressure*
- 1
- 2
- 3
- 4
Spinal Mobilization*
- 1
- 2
- 3
- 4
Extremity Mobilization*
- 1
- 2
- 3
- 4
Myofacial Release*
- 1
- 2
- 3
- 4
Craniosacral Techniques*
- 1
- 2
- 3
- 4
Cervical Traction*
- 1
- 2
- 3
- 4
Lumbar Traction*
- 1
- 2
- 3
- 4
Activities of Daily Living*
- 1
- 2
- 3
- 4
Gait Training*
- 1
- 2
- 3
- 4
Transfers*
- 1
- 2
- 3
- 4
Sports Medicine*
- 1
- 2
- 3
- 4
Athletic Injuries*
- 1
- 2
- 3
- 4
Biodex*
- 1
- 2
- 3
- 4
Cybex*
- 1
- 2
- 3
- 4
Orthotron*
- 1
- 2
- 3
- 4
Other:
Chest PT*
- 1
- 2
- 3
- 4
Cardiac Rehab*
- 1
- 2
- 3
- 4
ICU Procedures*
- 1
- 2
- 3
- 4
CCU Procedures*
- 1
- 2
- 3
- 4
SICU Procedures*
- 1
- 2
- 3
- 4
Burn Management*
- 1
- 2
- 3
- 4
Work Hardening - Work Site Eval*
- 1
- 2
- 3
- 4
Work Capacity Eval*
- 1
- 2
- 3
- 4
Functional Capacity Eval*
- 1
- 2
- 3
- 4
Muscle Energy Techniques*
- 1
- 2
- 3
- 4
Skilled Nursing Documentation*
- 1
- 2
- 3
- 4
Medicare A*
- 1
- 2
- 3
- 4
Medicare B*
- 1
- 2
- 3
- 4
State Healthcare*
- 1
- 2
- 3
- 4
Skilled Nursing Documentation*
- 1
- 2
- 3
- 4
Electronic Documentation*
- 1
- 2
- 3
- 4
List Types:
Electronic Documentation*
- 1
- 2
- 3
- 4
List Types:
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:
Newborn (birth-30 days)*
- 1
- 2
- 3
- 4
Infant (30 days - 1 year)*
- 1
- 2
- 3
- 4
Toddler (1 - 3 years)*
- 1
- 2
- 3
- 4
Preschooler (3 - 5 years)*
- 1
- 2
- 3
- 4
Toddler (1 - 3 years)*
- 1
- 2
- 3
- 4
School Age (5 - 12 years)*
- 1
- 2
- 3
- 4
Adolescents (12 - 18 years)*
- 1
- 2
- 3
- 4
Young Adults (18 - 39 years)*
- 1
- 2
- 3
- 4
Middle Adults (39 - 64 years)*
- 1
- 2
- 3
- 4
Older Adults (64+ years)*
- 1
- 2
- 3
- 4
Application Agreement*
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.*
Name*
First Last
Email*
Phone*
Today's Date*
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Skills Checklist

Setting

Adult Orthopedic

Neurologic:

Adult: Prosthetics / Orthotics:

Sports Medicine:

Procedures / Treatments:

Other:

Age-Appropriate Care:

Age: