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
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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Text version
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 .