Attachment E - Nurse Profile Checklist.xlsx
XLSX spreadsheet 12 KB Posted
- Attached to
- Non-Personal Healthcare Services for Emergency Department at the Gallup Indian Medical Center
- Solicitation number
- 75H71025Q00131
About this file
The file is a Nurse Profile Checklist template for a non-personal healthcare services contract with the Indian Health Service. The document is designed to capture comprehensive administrative and certification details for Registered Nurses (RNs) applying to work in the Emergency Department at the Gallup Indian Medical Center in New Mexico. The checklist requires documentation including current/updated resume, OIG clearance, active/inactive RN license, references, skills inventories, and various mandatory certifications such as BCLS, ACLS, TNCC, PALS, and specialized nursing course certificates.
The related federal contract opportunity (Solicitation 75H71025Q00131) seeks forty (40) qualified RNs for the Emergency Department, with an unrestricted acquisition strategy that includes small business set-asides: 10 ISBEE (Indigenous Small Business) and 10 Small Businesses. The solicitation emphasizes that personnel submitted by multiple offerors will not be considered, and multiple awards may be possible. The contract is issued by the Department of Health and Human Services Indian Health Service, targeting healthcare staffing needs at the Gallup Indian Medical Center in New Mexico.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Sheet1
| REGISTERED NURSE PROFILE CHECKLIST | |||
| RN NAME: __________________________________________ | RN Current Phone Number: _____________________________ | ||
| UNIT APPLYING FOR: __________________________________ | RN Email Address: ____________________________________ | ||
| COMPANY: __________________________________________ | |||
| COMPANY POC & PH #: ________________________________ | Nurse Availability Date: _________________________________ | ||
| ___________________________________________________ | |||
| ADMINISTRATIVE DOCUMENTS: | Date Rec'd: | Attached: | Comments: |
| Current/Updated resume |
| OIG Clearance |
| RN Active License |
| RN Inactive License |
| 2 current References |
| RN Skills Inventory Checklist |
| Scrub Tech Skills Inventory Checklist |
| CERTIFICATIONS DOCUMENTS (based on Specialty) |
| BCLS (Mandatory) Expire Date: |
| ACLS |
| TNCC Or Advance Trauma Care Nurse or Trauma Nurse Spec. |
| PALS |
| WCON |
| NRP |
| Fetal Monitoring Course Certificate |
| ENPC |
revised: SLA 10.18.21
Sheet2
Sheet3
File details come from the government source that posted it. Updated .