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#17-001755-0039
Supplemental Questionnaire

Last Name
First Name

 

***Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit.***


1.

Do you have 60 credit hours from an accredited college or university?

Yes No
2.

Describe your experience with HIPPA, Code of Maryland Regulations (COMAR) and confidentiality laws and policies.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.

3.

Describe your experience with managing multiple priorities in a fast-paced, goals/solutions oriented work environment.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below.

4.

Please describe your experience with Microsoft Office applications. Include the name of the Microsoft applications you have used along with the type of experience with each application.  If you do not have this experience, please enter N/A.


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