MINIMUM QUALIFICATIONS CHECKLIST



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In addition to answering the questions below regarding your qualifications, please submit a CV and cover letter with your application. Your cover letter should address why you are interested in working at Unity Care NW and describe your experience in a position of this type.

|QUALIFICATIONS |Yes |No |

|Do you have an AS or BS in Dental Hygiene? | | |

|Do you have a current, unrestricted Washington State Dental Hygienist License? | | |

|Do you have current CPR and Basic Life Support (BLS) certifications? | | |

|Do you have two or more years’ experience as a dental hygienist (preferred)? Please indicate number of years | | |

|experience and any specialties:       | | |

|Do you have experience in pediatric dentistry? Please indicate number of years experience:       | | |

|Do you have experience in a community or public health setting (preferred)? If yes, please indicate type of | | |

|setting:       | | |

|Are you knowledgeable about basic dental policies and procedures and oral health issues, especially regarding oral | | |

|hygiene? | | |

|Do you have the ability to place and finish restorative materials and sealants? | | |

|Are you able to work full-time? | | |

|Are you able to work part-time? | | |

|Are you competent in general office skills such as computers, faxes, telephones, and copy machines? | | |

|Are you able to maintain effective and positive professional working relationships with staff and patients at all | | |

|times? | | |

|The Centers for Disease Control and Prevention strongly recommends the following vaccines for healthcare workers:  | | |

|Influenza, Measles, Mumps and Rubella (MMR), Varicella (Chickenpox), Tdap (Tetanus, Diphtheria, Pertussis) and | | |

|Tuberculosis screening. As a Unity Care NW employee, would you agree to follow these CDC recommendations? | | |

|Are you able to understand and respond effectively and with sensitivity to children and special populations served | | |

|by UCNW? Special populations include those defined by race, ethnicity, language, age, sex, sexual orientation, | | |

|economic standing, disability, migrant and seasonal workers, homeless and others. | | |

|Are you able to perform the essential functions of the job as listed in the Job Description? Please indicate | | |

|exceptions:      | | |

I hereby certify that all statements made above are true and correct.

     

Signature Date

     

Print Name

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QUALIFICATIONS CHECKLIST

Dent䡮䡲䡳䤬䤭䤮䤯䤽䤾䤿䥁䥂䥐䥑䥒䥔䥛䦏䧂䧈䧌䧍䧎䧘뿐馮膮꺙꺙饩뾮뾮뾮咮Cᔠ⥨ᡯᘀ졨㰃䌀ᙊ伀Ɋ儀Ɋ帀Ɋ愀ᙊ̩jᔀ⥨ᡯᘀ졨㰃䌀ᙊ伀Ɋ儀Ɋ唀Ĉ䩞[?]䩡ȯ脈樃ﭓ

ࠆᔁ⥨ᡯᘀ汨癯䌀ᙊ伀Ɋ儀Ɋ唀Ĉ䩞[?]䩡ȯ脈樃﫟

ࠆᔁ⥨ᡯᘀ汨癯䌀ᙊ伀Ɋ儀Ɋ唀Ĉ䩞[?]䩡̩jᔀ⥨ᡯᘀ汨癯䌀ᙊ伀Ɋ儀Ɋ唀Ĉ䩞[?]䩡ᔠ⥨ᡯᘀ汨癯䌀ᙊ伀Ɋ儀Ɋ帀Ɋ愀ᙊᔠ⥨ᡯᘀ깨贐䌀ᙊ伀Ɋ儀Ɋ帀Ɋ愀ᙊᔠ⥨ᡯᘀ赨畟䌀ᙊ伀Ɋ儀Ɋ帀Ɋ愀ᙊᔠal Hygienist

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