The following checklist is a profile used to assess your Physical Therapy proficiency and assist in matching your skills with available assignments. Your employment is not dependent upon responses given on this checklist. Please rate your ability as accurately as possible by checking the appropriate option. Step 1 of 9 11% Name* First Middle Last Email* PLEASE MARK YOUR LEVEL OF EXPERIENCE 0 - No Experience 1 - Theory/Observed Only 2 - Intermittent Experience 3 - Moderate Experience 4 – Expert Work SettingsAdult/Adult ICU01234Children’s hospital01234General acute care01234Home health care01234Outpatient neuro01234Outpatient ortho01234Pediatrics/PICU01234Psychiatric hospital01234Rehabilitation hospital01234School setting01234Early intervention01234Skilled care facility01234Subacute01234 OrthopedicsUpper extremities01234Arthritis programs01234Back syndrome01234Cervical injuries01234Chronic fatigue syndrome01234Fibromyalgia01234Halo traction01234Hand injury01234Hip fracture01234Kyphoplasty01234Manual therapy01234Mobilization techniques01234Pelvic fracture01234Postpolio syndrome01234Shoulder injuries01234TMJ dysfunction01234Total hip/total knee01234Total joint replacement01234Total shoulder/CPM01234 NeurologicALS01234Brain tumors01234Cerebral palsy01234Multiple sclerosis01234Muscular dystrophy01234Polio/post polio syndrome01234Spinal cord injury01234Adaptive equipment01234Functional splinting01234Neurodevelopmental testing (NDT)01234Head trauma01234Glasgow coma scale01234Stroke rehabilitation01234Wheelchair prescription01234 PediatricsActivities of daily living01234Adaptive01234Developmental disability01234Equipment assessment01234Individualized education programs01234Neurodevelopmental testing (NDT)01234Orthotics01234Sequencing testing01234 Sports MedicineBiodex01234Bracing/joint01234Cybex01234Immobilization01234Lido01234Medical expenses (Norwegian)01234Nautilus/eagle01234Orthotron/kinetron01234Stabilization techniques01234Swiss ball01234Taping/strapping01234Prosthetics/OrthoticsDynamic splints01234LE prosthetics01234Protonics01234Removeable rigid dressings01234Serial casting01234Static splints01234UE prosthetics01234 ModalitiesAnodyne01234Biofeedback01234Edema massage01234Fluidotherapy01234Iontophoresis01234JOBST compression pump01234Muscle stimulation01234Paraffin bath01234Phonophoresis01234TENS01234Therapeutic pool01234Ultrasound01234 OtherBurn management01234Cardiac rehabilitation01234Chest physical therapy01234DME ordering01234FIM scoring01234Job task analysis01234Lymphedema management01234OASIS assessment for home care01234Obstetrics in physical therapy01234Tone management/spasticity01234Wheelchair ordering for SCI patients01234Work capacity evaluation01234Work hardening01234Wound care01234Knowledge of payment sources01234Medicare01234Medicaid01234MDS01234 General SkillsPatient/family teaching01234Patients in isolation01234Patients in restraints01234Initial evaluation01234Lift/transfer devices01234Specialty beds01234End of life care/palliative care01234Computerized Charting01234Cerner01234EPIC01234McKesson01234Meditech01234National Patient Safety Goals01234Accurate patient identification01234Effective communication01234Pain assessment & management01234Infection control01234Universal precautions01234Care of patients in isolation01234Minimize risk of falls01234Prevention of pressure ulcers01234 Age Specific CompetenciesInfant (birth to 1 year)01234Toddler (ages 1-3 years)01234Preschooler (ages 3-5 years)01234Childhood (ages 6-12 years)01234Adolescents (ages 12-21 years)01234Young Adults (ages 21-39 years)01234Adults (ages 40-64 years)01234Older Adults (ages 65-79 years)01234Elderly (ages 80+ years)01234AcceptanceThe information I have given is true and accurate to the best of my knowledge. In addition, I hearby authorize Fidelis Partners to release this profile to client institutions of Fidelis Partners in consideration of my employment with that institution.Signature*Use your mouse or finger (mobile or tablet device) to draw your signature.