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Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently

Work Settings
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Adult/adult ICU
Children’s hospital
General acute care
Home health care
Outpatient neuro
Outpatient ortho
Pediatrics/PICU
Psychiatric hospital
Rehabilitation hospital
School setting
Early intervention
Skilled care facility
Subacute
IV THERAPY
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Starting & maintaining peripheral IVs
Venous blood draw
Orthopedics Experience
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Upper extremities
Arthritis programs
Back syndrome
Cervical injuries
Chronic fatigue syndrome
Fibromyalgia
Halo traction
Hand injury
Hip fracture
Kyphoplasty
Manual therapy
Mobilization techniques
Pelvic fracture
Postpolio syndrome
Shoulder injuries
TMJ dysfunction
Total hip/total knee
Total joint replacement
Total shoulder/CPM
Neurologic Experience
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
ALS
Brain tumors
Cerebral palsy
Multiple sclerosis
Muscular dystrophy
Polio/post polio syndrome
Spinal cord injury
Adaptive equipment
Functional splinting
Neurodevelopmental testing (NDT)
Head trauma
Glasgow coma scale
Stroke rehabilitation
Wheelchair prescription
Pediatrics Experience
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Activities of daily living
Adaptive
Developmental disability
Equipment assessment
Individualized education programs
Neurodevelopmental testing (NDT)
Orthotics
Sequencing testing
Sports Medicine Experience
Biodex
Bracing/joint
Cybex
Immobilization
Lido
Medical expenses (Norwegian)
Nautilus/eagle
Orthotron/kinetron
Stabilization techniques
Swiss ball
Taping/strapping
Prosthetics/Orthotics Experience
Dynamic splints
LE prosthetics
Protonics
Removeable rigid dressings
Serial casting
Static splints
UE prosthetics
Modalities Experience
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Anodyne
Biofeedback
Edema massage
Fluidotherapy
Iontophoresis
JOBST compression pump
Muscle stimulation
Paraffin bath
Phonophoresis
TENS
Therapeutic pool
Ultrasound
Other Experience
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Burn management
Cardiac rehabilitation
Chest physical therapy
DME ordering
FIM scoring
Job task analysis
Lymphedema management
OASIS assessment for home care
Obstetrics in physical therapy
Tone management/spasticity
Wheelchair ordering for SCI patients
Work capacity evaluation
Work hardening
Wound care
Knowledge of payment sources
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Medicare
Medicaid
MDS
General Skills Experience
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Patient/family teaching
Patients in isolation
Patients in restraints
Initial evaluation
Lift/transfer devices
Specialty beds
End of life care/palliative care
Computerized Charting
Cerner
EPIC
McKesson
Meditech
National Patient Safety Goals
Accurate patient identification
Effective communication
Pain assessment & management
Infection control
Universal precautions
Care of patients in isolation
Minimize risk of falls
Prevention of pressure ulcers
Age Specific Competencies Experience
(1) Limited or no experience
(2) Experienced, but may need review or supervision
(3) Able to function independently *
 123
Infant (birth to 1 year)
Toddler (ages 1-3 years)
Preschooler (ages 3-5 years)
Childhood (ages 6-12 years)
Adolescents (ages 12-21 years)
Young Adults (ages 21-39 years)
Adults (ages 40-64 years)
Older Adults (ages 65-79 years)
Elderly (ages 80+ years)
ATTESTATION *