**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**
1.
Are you a current employee of the MDH, Office of Health Care Quality?
Yes
No
2.
Do you have a Bachelor's degree from an accredited college or university in nursing, social work, psychology, education or counseling? (This information must be listed on your application in order to receive credit.)
Yes
No
3.
Describe your professional experience in health services. Health services is defined as experience in areas other than Mental Health, Developmental Disabilities or Addictions.
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.
Describe your experience at the managerial and/or supervisory level, especially in a Psychiatric setting.
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.
Department of Budget and Management