Official SealSan Joaquin County Human Resources Division


#1223-RH3031-FL
Supplemental Questionnaire

Last Name
First Name
 

Have you completed an approved operating room technician training or program within the past five (5) years? If yes, please be sure to complete the Education portion of the application in detail.
Yes No
 

If yes, did the program include completion of 500 externship hours?
Yes No
 

Do you possess one year performing scrub duties in an out-patient surgery facility or clinic? If yes, please be sure to complete the Employment History portion of the application in detail. 
Yes No
 

This position will require employees to work rotational assignments of "on-call" duty. When on-call, employees must be able to report to San Joaquin General Hospital's OR Department within 30 minutes of being contacted.

By selecting "yes", you are indicating that you understand that during your rotational assignment, you are required to report to the San Joaquin General Hospital's OR Department within 30 minutes of being contacted for on-call duty.
Yes No