Self-Assessment Overall Average Rating

1 = No experience (Theory or observation only during the past 12 months)

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

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

4 = Highly Skilled (Performed on at least a weekly basis over the past 12 months; proficient)

Orthopedics

1

2

3

4

Equipment - Support Device - Wheel Chair

Emergencies

1

2

3

4

Assist physician with patient - Bleeding

Assist physician with patient - Burns

Assist physician with patient - Cardiac/Respiratory arrest

Assist physician with patient - Choking

Assist physician with patient - Fracture

Assist physician with patient - Poisoning

Office Duties

1

2

3

4

Perform - Answer phone

Perform - Coding

Perform - Invoicing

Perform - Medical billing

Perform - Medical filing

Perform - Medical record organization

Perform - Order supplies

Perform - Schedule Patient Appointment

Perform - Transcription

Body Systems

1

2

3

4

Cardiovascular system

Digestive system

Endocrine system

Nervous system

Reproductive system

Respiratory system

Urinary system

Age Groups

1

2

3

4

12-18 years old (Adolescents)

1-3 years old (Toddler)

18-39 years old (Young Adults)

3-5 years old (Preschool)

Personal Information

Self-Assessment Overall Average Rating

Orthopedics

Lab Tests:

Emergencies

General

Office Duties

Orthopedics

Body Systems

Monitor Chart

Age Groups