MEDICAL ASSISTANT SKILLS PROFICIENCY CHECKLIST www.favoritestaffing.com Name: Date: Please select the column that most accurately describes your proficiency level. NOTE: The checklist is by system, so please review all skills. KEY: 1 - PERFORMS PROFICIENTLY AND INDEPENDENTLY 2 - SOME EXPERIENCE (Assistance Required) or CLASSROOM TRAINING (Never Performed) 3 - NO TRAINING OR EXPERIENCE 1 2 3 General Clinical Skills Vital Signs Obtaining Medical Histories Height/Weight Blood Pressure Peripheral Pulses Draping and Preparing Patients for Exams Explaining Treatment Procedures Dressing Changes Sterile Technique Ear Irrigation Enemas Medication Administration Oral Injection Optic Suture Removal Autoclave Use 1 2 OB/GYN Assisting with Procedures Vaginal Exam Colposcopy Cryosurgery IUD Insertion D& C Cultures Pap Smears Fetal Doppler Fetal Non-Stress Test Perineal Care Douches Use of Contraceptives Pediatrics Height/Weight Head Circumference Immunizations Lab Skills Venipuncture Urine Dipstick – Routine Midstream Urine Analysis Collection Clean Catch Urine Analysis Collection Urine Drug Screen Collection (legalities) Throat Cultures Wound Cultures Accucheck Front Office Scheduling Appointments Update & File Medical Records Insurance Forms Correspondence Billing Bookkeeping Word-processing Skills Typing Orthopedics Ace Wraps Casting Splinting Crutch Assembly Crutchwaliking Instruction Cane Instruction Physical Testing EKG Visual Screens Holter Monitor Peak Flow Meter Pulmonary Function Test Glaucoma Screen Audiometry –Automatic Audiometry - Manual The information I have given is true and accurate to the best of my knowledge. I hereby authorize Favorite Healthcare Staffing to release this skills proficiency checklist to its client facilities in relationship to my employment with that institution. Employee Signature Branch Representative FHS101 (Rev. 09/06) Date Branch No./Location Date 3