SLP Skills Checklist Skills Checklist
Please rate your level of proficiency of each of the following skills on a scale of 0 to 5.
0
: Unfamiliar With
1
: Theory; no practice
2
: Familiar; need review
3
: Some experience; need minimal review
4
: Frequent experience; performs well
5
: Expert Experience
In order to associate these ratings with you,
please provide us with your name AND email address.
First Name:
*
Last Name:
*
Email Address:
*
Advanced/Additional Skills
0
1
2
3
4
5
Performing an MBS
0
1
2
3
4
5
Augmentative Communication Devices
0
1
2
3
4
5
Laryngectomee
0
1
2
3
4
5
Flex to Outpatient
0
1
2
3
4
5
Flex to Acute Care
0
1
2
3
4
5
Mentor for New Staff in Department
0
1
2
3
4
5
Student Supervision
Communication (oral-written)
0
1
2
3
4
5
Written-Timeliness/Thoroughness/Orderly
0
1
2
3
4
5
Departmental In-services
Competency & Skill Level
0
1
2
3
4
5
Basic Computer Skills
0
1
2
3
4
5
CFY Supervision
0
1
2
3
4
5
Facility-wide in-services
0
1
2
3
4
5
Offsite In-services
0
1
2
3
4
5
Basic Sign Language Skills
0
1
2
3
4
5
Speak a Foreign Language (that can be used for therapy purposes)
Evaluation
0
1
2
3
4
5
Memory
0
1
2
3
4
5
Voice
0
1
2
3
4
5
Orientation
0
1
2
3
4
5
Hearing
0
1
2
3
4
5
Swallowing
0
1
2
3
4
5
Auditory Comprehension
0
1
2
3
4
5
Visual/Reading Comprehension
0
1
2
3
4
5
Language Expression
0
1
2
3
4
5
Non-verbal Communication
0
1
2
3
4
5
Written Expression
0
1
2
3
4
5
Oral Motor/Speech Intelligibility
0
1
2
3
4
5
Problem-Solving/Judgement
0
1
2
3
4
5
Pragmatics
0
1
2
3
4
5
Attention/Organization
0
1
2
3
4
5
Number Concepts
I certify that all of the above information is correct and that any misrepresentation or falsification of fact may be considered sufficient cause for immediate dismissal from Medical Methods. I have completed this skills checklist to the best of my knowledge and agree that all of the information provided is correct.
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