Official SealSan Joaquin County Human Resources Division


#1118-RH0240-TM
Supplemental Questionnaire

Last Name
First Name
1

Do you possess one year of full-time (40 hours per week) paid experience as a trauma registrar in an acute care hospital?

Please note: Acute care is a level of care where patients are treated for a brief acute episode of illness, for conditions that are the results of a disease or trauma, and during recovery from surgery. Acute care is generally only provided in hospitals where all of the following medical units/services are provided:

  • Emergency
  • Medical Surgical
  • Labor and Delivery
  • Intensive Care Unit
Yes No
1a

Please identify if your experience included the following:

Trauma data base system development and maintenance
Statistical reporting and analysis of patient data
Generating and preparing reports
Knowledge of Abbreviated Injury Scale/Injury Severity Scores (AIS/ISS)
Knowledge of ICD9/ICD10 codes
All of the above
None of the above
1b

If you answered yes to question #1, provide the following information:

  • Name of the acute care hospital in which you performed duties of a trauma registrar
  • Employment dates (from/to)
  • Number of hours worked per week
  • Job Title
  • Specific duties performed
  • Trauma data base system(s) utilized
2

Do you possess a current certification as a Certified Trauma Registrar by the American Trauma Society?

If qualifying under this requirement, a copy of the certificate must be submitted with the completed employment application. It may be uploaded when prompted for a resume, sent to msneed@sjgh.org, or faxed to (209) 468-6271.

Yes No