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Human Capital Management
#180108-K20B-01


Supplemental Questionnaire

Last Name First Name
 
 

What experience do you have providing skilled technical assistance to vocational rehabilitation staff?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have gathering information and assisting clients or applicants in the completion of paperwork?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have interacting with medical staff to arrange examinations or procedures?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 
 

What experience do you have implementing specified services that are included in an approved vocational rehabilitation plan?

I have performed this task independently as regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have maintaining electronic files through a management information system?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 

Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below. 

 

What experience do you have performing tasks related to general office operations (for example:  answering multiple phone lines, providing customer service, or maintaining copy/fax/scanning machines)?

I have performed this task independently as a regular part of my job.
I have performed this task under supervision as a regular part of my job.
I am familiar with this task or have received some training on it.
I have no experience with this task.
 
Please list the employer and job title where you gained your experience as indicated in the response above.  If you indicated "no experience", then please type N/A below.