CYNET_SYSTEMS_MAIN_LOGO.gif   MRI Tech Skills
   NAME    
   LAST 4 OF SSN      
   DATE    
I hereby certify that ALL information I have provided to IMCS Group on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.  
Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.  
Proficiency Scale: 1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently

  
       
Rating Stars (Click) WORK SETTINGS 1 2 3 4  
Adult Acute Care  
Adult Outpatient  
Pediatric Acute Care  
Pediatric Outpatient  
Trauma  
Outpatient Clinica/Free-Standing clinic  
Mobile  
Supervisory/Management Experience  
Rating Stars (Click) ANGIO STUDIES 1 2 3 4  
Abdominal Aorta  
Chest/Arch  
Circle of Willis  
Upper & Lower Extremities  
Carotids/Neck  
Renal Arteries  
Subclavian  
Rating Stars (Click) VENOGRAM STUDIES 1 2 3 4  
Carotids/Neck  
Renal Arteries  
Pelvis  
Upper & Lower Extremities  
Rating Stars (Click) MR STUDIES 1 2 3 4  
Cardiac MRI  
Head/Neck  
Brain/Head w-w/o Contrast  
Face w-w/o Contrast  
Pituitary w-w/o Contrast  
Soft Tissue Neck w-w/o Contrast  
TMJ w-w/o Contrast  
Rating Stars (Click) ABDOMEN/PELVIS 1 2 3 4  
Abdomen w-w/o Contrast  
Adrenals w-w/o Contrast  
Cholangiogram  
Pelvis w-w/o Contrast  
Sacroiliac Joint w-w/o Contrast  
Renal w-w/o Contrast  
Rating Stars (Click) CHEST 1 2 3 4  
Brachial Plexus  
Breast w-w/o Contrast  
Chest w-w/o Contrast  
Myocardium w-w/o Contrast  
Sternum w-w/o Contrast  
Rating Stars (Click) SPINE 1 2 3 4  
Cervical Spine w-w/o Contrast  
Thoracic Spine w-w/o Contrast  
Lumbar Spine w-w/o Contrast  
Sacrum w-w/o Contrast  
Rating Stars (Click) UPPER EXTREMITIES 1 2 3 4  
Scapula w-w/o Contrast  
Shoulder w-w/o Contrast  
Arthogram Shoulder  
Elbow/Wrist w-w/o Contrast  
Hand/Finger w-w/o Contrast  
Humerus w-w/o Contrast  
Rating Stars (Click) LOWER EXTREMITIES 1 2 3 4  
Hip w-w/o Contrast  
Knee w-w/o Contrast  
Foot/Ankle w-w/o Contrast  
Femur/Tibia w-w/o Contrast  
Rating Stars (Click) PHASE ARRAY 1 2 3 4  
Head  
Neurovascular  
Spine  
Torso  
Rating Stars (Click) SURFACE COILS 1 2 3 4  
Extremity  
Shoulder  
TMJ  
Rating Stars (Click) IMAGES 1 2 3 4  
Echo Planar Imaging - EPI  
Gradient Echo Imaging  
Multiplanar Reconstruction/MRA  
Spin Echo Images  
T-1 weighted  
T-2 weighted  
Inversion Recovery  
Fat Supression  
Fiesta  
Rating Stars (Click) PROFESSIONAL KNOWLEDGE AND SKILLS 1 2 3 4  
National Patient Safety Goals  
Computerized Charting  
Venipuncture  
Contrast Administration  
Imaging a Patient with Conscious Sedation  
Imaging a Patient under Anesthesia  
Patient Isolation/Infection Prevention  
Rating Stars (Click) MRI IMAGING SYSTEMS  
  GE Signa    
  1.5T Magnet Strength
   
  3T Magnet Strength
   
  Model (List):  
  Siemens  
  1.5T Magnet Strength
   
  3T Magnet Strength
   
  Model (List):  
  Hitachi  
  1.5T Magnet Strength
   
  3T Magnet Strength
   
  Model (List):  
  Phillips  
  1.5T Magnet Strength
   
  3T Magnet Strength
   
  Model (List):  
  Other  
  1.5T Magnet Strength
   
  3T Magnet Strength
   
  Model (List):  
Rating Stars (Click) CERTIFICATIONS/LICENSURES/REGISTRATIONS  
  EMR Conversion
   
  ARRT
   
  ARRT (MR) (National Certification)
   
Rating Stars (Click) State Licenses:  
  State (List)  
  Other  
Rating Stars (Click) EMR 1 2 3 4  
Epic  
Cerner  
Eclipsys  
McKesson  
Meditech  
Other Computerized System  
Computerized Physician Order Entry  
Bar Coding for Medication Administration  
MY EXPERIENCE IS PRIMARILY IN:  
Unit No. of Years Unit No. of Years  
BURN POST PARTUM  
CRITICAL UNIT LABOR & DELIVERY  
PACU NEWBORN NURSERY  
NEUROLOGY LEVEL II NICU  
TELEMETRY LEVEL III NICU  
MEDICAL PICU  
SURGICAL  PEDIATRICS  
ONCOLOGY OB/GYN  
ORTHOPEDICS PSYCHIATRY  
OPERATING ROOM RRT  
EMERGENCY ROOM CRT  
TRAUMA CENTER LEVEL 1    
COMMUNITY ER    
RURAL ER    
Rating Stars (Click) AGE APPROPRIATE CARE 1 2 3 4  
Newborn/Neonatal (birth – 30 days)          
Infant (30 days-1 year)          
Toddler (1-3 years)          
Preschool (3-5 years)          
School Age Children (5-12 years)          
Adolescent (12-17 years)          
Young Adults (18-44 years)          
Middle Adults (45-64 years)          
Older Adults (>65 years)