Section_J,_ATTACHMENT_AD_Computer_Skills_Competency_Form.docx

ATTACHMENT AD

COMPUTER SKILLS COMPETENCY FORM

HCW’s name:_________________________________________________________

Position:______________________________________________________________

Company:_____________________________________________________________

Basic Knowledge

Use of Mouse

Ability to move about in a windows based program

Ability to navigate on the desktop

Ability to draft and print a short memo

Locate files

Open and Close files

Ability to open and reply to email

Ability to Name and retrieve files

Ability to Save & Print Files

Specific Knowledge

Ability to bring system up & shut down

Enter /change password

COMPANY REPRESENTATIVE:

The above named health care worker has been personally tested by me and I certify that he/she is competent in all the areas listed above.

Printed Name

Signature Date