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CT Technologist
Radiology: CT
Name
*
First
Last
Date
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
Radiography
No Experience
Limited Experience
Experienced
Highly Skilled
Abdomen - Abdominal Series
Abdomen - Erect/Decubitis Film
Equipment - Automatic Processing/Darkroom
Equipment - C-Arm
Equipment - Daylight Systems
Equipment - Panoramix
Equipment - Portable Exams
Equipment - R&F Rooms
Equipment - Large Extremeties
Equipment - Small Extremeties
Flouroscopy/Special Exams - GI Tract (Upper and Lower)
Flouroscopy/Special Exams - Hysterosalpingogram
Flouroscopy/Special Exams - IVP/Tomograms
Flouroscopy/Special Exams - Myelogram
Flouroscopy/Special Exams - Surgery (C-Arm/Portable)
Flouroscopy/Special Exams - Swallowing Functions
Flouroscopy/Special Exams - Trauma Cases
Head/Skull - Facial Bones
Head/Skull - Mandible
Head/Skull - Nasal Bones
Head/Skull - Orbits
Pediatric - Chest/Abdomen
Pediatric - Extremities
Pediatric - Head Work
Pediatric - Spine
Spine/Pelvis - Lumbar Spine
Spine/Pelvis - Scoliosis Studies
Spine/Pelvis - SI Joints
Spine/Pelvis - Thoracic Spine
Thorax - Decubitis Chest
Thorax - PA/Lat Chest
Thorax - Ribs
Thorax - Sternum
CT
No Experience
Limited Experience
Experienced
Highly Skilled
3-D or Multidimensional
Abdomen Studies
Biopsy/Angio Procedures
Brain with Contrast
Bran without Contrast
Cervical Spine
Chest
Lumbar Spine
PET Scan
Skull/Facial/Orbits/Sinus
Thoracic Spine
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