Histotechnologist Skills Checklist

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Requested by email:

Today's Date: * +

First Name: *

Last Name: *

Mobile Phone Number: *

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SETTINGS

Rank each of the following sections on a scale of 1 to 4:

1) No Experience

2 )Limited Experience

3) Experienced

4 )Very Experienced

*

Free Standing Lab	1234
Reference Lab	1234
Specialty Lab	1234

TISSUE PROCESSING

Rank each of the following sections on a scale of 1 to 4:

1) No Experience

2 )Limited Experience

3) Experienced

4 )Very Experienced

*

Histology Universal Precautions	1234
Routine Processing Schedule	1234
GI Processing Schedule	1234
Microwave Processing	1234
Frozen Section Processing	1234
Bone Decal	1234
Bone Marrow Processing & Decal	1234
Follow Recommended Protocol for Sample	1234
Processor Quality Control & Maintenance	1234

EMBEDDING

Rank each of the following sections on a scale of 1 to 4:

1) No Experience

2 )Limited Experience

3) Experienced

4 )Very Experienced

*

Embedding Skin	1234
Embedding Large Specimens	1234
Embedding GI Specimens	1234
Embedding on Edge	1234
Embedding on End	1234
Special Embedding Instructions	1234
Removing Foreign Objects as Allowed by Protocol	1234
Embedding Quality Control & Maintenance	1234

MICROTOMY

Rank each of the following sections on a scale of 1 to 4:

1) No Experience

2 )Limited Experience

3) Experienced

4 )Very Experienced

*

Automated Microtome	1234
Manual Microtome	1234
Microtomy of Hard Tissue	1234
Microtomy of Fatty Tissue	1234
Microtomy of Frozen Sections	1234
Microtome Quality Control & Maintenance	1234

IMMUNOHISTOCHEMISTRY

Rank each of the following sections on a scale of 1 to 4:

1) No Experience

2 )Limited Experience

3) Experienced

4 )Very Experienced

*

Manual	1234
Automated	1234
Purchased Antibodies	1234
Antibody Aliquot	1234
Multiple Chromogens	1234
Protocols per Instrument	1234
Protocols per Hand	1234
Maintain Supply Inventory	1234
IHC Stainers	1234
Quality Control & Maintenance	1234
Record Keeping/Maintenance	1234

ROUTINE/SPECIAL STAINS

Rank each of the following sections on a scale of 1 to 4:

1) No Experience

2 )Limited Experience

3) Experienced

4 )Very Experienced

*

Automated H & E	1234
Manual H & E	1234
Connective Tissue	1234
Fungal	1234
Microorganism	1234
Pigment/Mineral	1234
Automated Special Stains	1234
Manual Special Stains	1234
Special Staining Quality Control	1234

COVERSLIPPING

Rank each of the following sections on a scale of 1 to 4:

1) No Experience

2 )Limited Experience

3) Experienced

4 )Very Experienced

*

Automated	1234
Manual	1234

INSTRUMENTATION

Rank each of the following sections on a scale of 1 to 4:

1) No Experience

2 )Limited Experience

3) Experienced

4 )Very Experienced

*

Thin Prep Processor	1234
Sure Path	1234
Focal Point Imaging	1234
Cytospin	1234
CoPath	1234
Sakura Tissue Processor	1234
Leika PELORIS	1234
Ventana Tissue Processor	1234
Thermo Scientific Processor	1234
Pathos Processor	1234

LAB INFORMATION SYSTEMS

Rank each of the following sections on a scale of 1 to 4:

1) No Experience

2 )Limited Experience

3) Experienced

4 )Very Experienced

*

Cerner	1234
Epic	1234
Meditech	1234
Sunquest	1234
Digital Imaging	1234

Attestation

ATTESTATION: *

I certify that the information provided above accurately reflects my experience in each of the clinical areas identified within the past three years.

If you agree with the Attestation above, please electronically sign your name. *