The following checklist is a profile used to assess your Speech Language Pathology 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 5 20% 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 SettingsGeneral acute care01234Rehabilitation Hospital01234Rehabilitation Clinic01234Children’s hospital01234Home Health Care01234Skilled Care Facility01234School Setting01234Long Term Acute Care01234Outpatient Setting01234 Neurological DisordersAdaptive Feeding01234ALS01234Alzheimer's (Dementia)01234Augmentative CommunicationsCommunication Boards01234Electronic Devices01234Aural RehabilitationHearing Aids01234Hearing Loss01234Dysarthria01234 DysphagiaTrachs01234Ventilator Dependent Patients01234Fluency01234Parkinson's Disease01234Therapy Techniques01234Voice-Laryngectomy01234PediatricsArticulation01234Autism01234Cleft Palate01234Early Intervention01234Feeding Disorders01234Hearing Impaired01234Traumatic Brain Injury01234 AphasiaCVA01234Head Trauma01234Low Level Functioning Patients01234Oral Motor DisordersApraxia01234Dysarthria01234Clinical SkillsStandardized Tests01234ALSP (Aphasia Language Performance Scale)01234Boston01234CADL (Communication Ability for Daily Living)01234Detroit01234Minnesota (Schuell)01234Pica (Porch Index of Communication Ability)01234Token01234WAB (Western Aphasia Battery)01234Screening01234General SkillsAbility to Follow Directions01234Attention Span01234Expressive/Receptive Skills01234Familiarize Self with Chart01234Hearing01234Memory Skills01234Oral Motor Movement01234 AcceptanceThe 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 (if on a mobile or tablet device) to draw your signature.