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CT/CAT Scan Tech

CT/CAT Scan Tech

  • MM slash DD slash YYYY

  • Self-Assessment Rating Scale:

    No Experience
    Theory or observation only during the past 12 months

    Limited Experience
    Performed less than 12 times within the past 12 months and may need a review

    Experienced
    Performed at least once per month within the past 12 months and may need minimal assistance

    Highly Skilled
    Performed on at least a weekly basis over the past 12 months; proficient
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Adult Acute Care
    ER/Trauma
    Adult Outpatient
    Pediatric Acute Care
    Pediatric Outpatient
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Brain with Contrast
    Brain without Contrast
    Circle of Wills
    Facial Bones/Maxillofacial
    IAC's
    Orbits
    Posterior Fossa
    Sinuses
    Temporal Bones
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Soft Tissue Neck
    Larynx
    Heart
    Lung
    Mediastinum
    Pulmonary Embolism Study
    Thoracic Aorta Dissection
    Vascular
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Abdominal Aortic Aneurysm
    Adrenals
    Appendicitis Study
    GI Tract: Abdomen without Contract
    GI Tract: Abdomen with Contrast
    GI Tract: Oral Contrast Studies
    GI Tract: Enema Contrast Studies
    GI Tract: IV Contrast Studies
    Kidney Studies/Urogram
    Liver
    Pancreas
    Renal Calculi Study
    Trauma Study: Triple Phase Studies
    Spleen: Trauma
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Pelvic Studies
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Joint Studies: Hip
    Joint Studies: Knee
    Joint Studies: Ankle
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Joint Studies: Shoulder
    Joint Studies: Elbow
    Joint Studies: Wrist
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Cervical
    Thoracic
    Lumbar
  • Please list and rate 1 - 4
    1 as No Experience
    2 as Limited Experience
    3 as Experienced
    4 as Highly Skilled
  • No ExperienceLimited ExperienceExperiencedHighly Skilled
    Newborn (birth-30 days)
    Infant (30 days-1 year)
    Toddler (1-3 years)
    Preschooler (3-5 years)
    School Age (5-12 years)
    Adolescents (12-18 years)
    Young Adults (18-39 years)
    Middle Adults (39-64 years)
    Senior Adults (64+ years)
  • ARRTARRT-CTFLUROSCOPYCRT

  • By signing below, I attest that the information contained above is accurate to the best of my knowledge, and that I am the individual completing this form. I further authorize the Company to release this Qualification List to the Client facilities in accordance with the consideration of employment as a Healthcare Professional with those facilities.
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