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Cytology
Cytology
Name
First
Last
Email
Phone
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
Cytology
No Experience
Limited Experience
Experienced
Highly Skilled
Gyn - Screen
Gyn - Review
Gyn - ThinPrep
Non-Gyn - Ascitic fluid
Non-Gyn - Bronchial
Non-Gyn - Esophageal
Non-Gyn - Gastric
Non-Gyn - Spinal
Non-Gyn - Urine
Non-Gyn - ThinPrep
Fixations
No Experience
Limited Experience
Experienced
Highly Skilled
Saccomanno
Cytolyt
Carbowax
95% alcohol
Filter prep
Fine needle aspirations - Assist
Fine needle aspirations - Make smears
Fine needle aspirations - Collection
Fine needle aspirations - Preliminary diagnosis
Fine needle aspirations - Onsite procedures
Fine needle aspirations - Staining
Special Stains/Organisms
No Experience
Limited Experience
Experienced
Highly Skilled
GMS
PAP
IRON
Other Skills
No Experience
Limited Experience
Experienced
Highly Skilled
Flow cytometry
DNA ploidy
FISH
Instrumentation
ALab computer systems (LIS)
Electronic documentation
Signature
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