Attachment E -WHU Scrub Tech Profile Checklist.xlsx

XLSX spreadsheet 12 KB Posted

Attached to
Non-Personal Healthcare Services for WHU Scrub Techs at the Gallup Indian Medical Center
Solicitation number
75H71022Q00032
Issued by

About this file

This document contains an attachment checklist for scrub technician profiles and a related federal contract opportunity solicitation. The attachment checklist provides an administrative document template for scrub technician applicants to submit required licensure, certification, and skills inventory documents to the Gallup Indian Medical Center. The related federal contract opportunity is solicitation number 75H71022Q00032 for non-personal healthcare services of scrub technicians at the Gallup Indian Medical Center in Gallup, New Mexico. The Department of Health and Human Services Indian Health Service is the contracting agency. The submission due date for responses is March 24, 2022 at 1:00pm Eastern Time. The solicitation seeks qualified, applicable, and available personnel for scrub technician positions, with the stipulation that any personnel submitted by multiple offerors will not be considered.

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Sheet1

WHU Scrub Tech 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 .