Attachment E - Registered Nurse Profile Checklist.xlsx

This is a checklist template form for documenting Registered Nurse credentials and qualifications, titled "Registered Nurse Profile Checklist." The form is associated with a solicitation from Indian Health Services for nursing services at the Gallup Indian Medical Center in New Mexico.

The checklist captures essential administrative documents including current resume, OIG clearance, active/inactive RN license, references, and skills inventory checklists. It also tracks required certifications with expiration dates, including mandatory BCLS, plus specialty certifications such as ACLS, TNCC (or equivalent trauma certifications), PALS, WCON, NRP, Fetal Monitoring, and ENPC. The form includes fields for nurse contact information, unit assignment, company details, availability date, and company point of contact.