Supplemental Questionnaire PBT-0932-071813 Imaging Director
The purpose of the Supplemental Questionnaire is to assist with determining if you possess the Minimum Qualifications for the 0932 Manager IV – Imaging Director.
If you experience technical difficulties, make note of any error messages and contact the analyst before the filing deadline. Responses should be consistent with the information on your employment application and are subject to verification.
1a.
Please select the highest level of education that you have completed.
High School Diploma or equivalent
Associate's degree
Bachelor's degree
Master's degree
Doctoral degree
None of the above
1b.
Please list the school(s) where you obtained your degree(s) as well as the discipline/field of study
and type of degree earned (e.g. Bachelor of Arts degree in Psychology from the San Jose State
University). If you do not possess any of the degrees identified above, type N/A.
2a.
How much experience do you have performing imaging procedures in a hospital setting?
I have no experience
I have less than 5 years (10,000 hours) of experience
I have between 5 years and 6 years (10,000 to 12,000 hours) of experience
I have between 6 years and 7 years (12,000 but under 14,000 hours) of experience
I have 7 years or more (14,000+) of experience
2b.
In accordance with your responses to #2 above, please provide the name of the employer(s) and the dates (e.g. MM/YYYY – MM/YYYY) where you obtained the verifiable full-time equivalent work experience.
Additionally, please list the name of (a) supervisor(s) or manager(s) who can verify the information provided as well as his or her contact information. If you do not have experience in these areas, please type N/A.
3a.
In reference to your experience in question 2a, how many years of that experience did you perform as supervisor and/or manager?
I do not have any supervisory experience in a hospital setting
I have less than 3 years(6000 hours)supervisory experience in a hospital setting
I have 3 years to 4 years(6000-8000 hours) supervisory experience in a hospital setting
I have 4 years to 5 years(8000-10,000 hours)supervisory experience in a hospital setting
I have more than 5 years of supervisory experience (10,000+hours) in a hospital setting
3b.
In accordance with your responses to #3 above, please provide the name of the employer(s) and the dates (e.g. MM/YYYY – MM/YYYY) where you obtained the verifiable full-time equivalent work experience.
Additionally, please list the name of (a) supervisor(s) or manager(s) who can verify the information provided as well as his or her contact information. If you do not have experience in these areas, please type N/A.
4a.
Do you have current registration with the American Registry of Radiologic Technologists (ARRT)?
Yes
No
4b.
Please type in your ARRT registration number. Type in N/A if you do not have current ARRT.
I understand that checking this box will serve as my electronic signature. I certify that I am the author of this questionnaire and all information presented is true and based upon my education, training, skills, and experience. I understand and agree that any information provided is subject to verification. I also understand that any false, incomplete, or incorrect statement may result in disqualification, termination, or dismissal from employment with the City and County of San Francisco.
Department of Human Resources