Complete each section of the application below and click the Submit button.

Full Name   (e.g. Last, First Middle)

Address  

Day Phone     (e.g. 123-456-7890)

Evening Phone    (e.g. 123-456-7890)

E-Mail Address   

Current CMT Certificate Number  

 

TRANSCRIPTION EXPERIENCE

Employer 1  

Address  

Supervisor 

Start Date    End Date  (e.g. MM/DD/YYYY)

Reason for Leaving

Give a brief description of the work you performed

 

Employer 2  

Address  

Supervisor 

Start Date    End Date  (e.g. MM/DD/YYYY)

Reason for Leaving

Give a brief description of the work you performed

 

Employer 3

Address  

Supervisor 

Start Date    End Date  (e.g. MM/DD/YYYY)

Reason for Leaving

Give a brief description of the work you performed

 

Please indicate the types of reports you have transcribed by how many years
experience you have with each type:

Discharge History....................
History & Physical...................
E.R.........................................
Operative Reports...................
Letters & Memos.....................
Radiology...............................
Consults..................................
Progress Notes........................
Pathology...............................
Testimonies............................
Telephone Consents...............
Medical Investigation Boards..

If you have ever transcribed providers with foreign or regional
accents, how many years of experience do you have?   

Do you have your own transcriptionist tools?
Pentium II or better
128 MB RAM
Serial Port for Wav Player
CD-ROM
Sound card

COMPUTER EXPERIENCE

How proficient are you with Microsoft Word?
Very Proficient   Proficient Somewhat Proficient A little knowledge No knowledge

What word processing program and version are you currently using?  

Which Windows version are you currently using?

What medical terminology software tools do you use?  

What internet service provider do you use?    

Have you worked with Tape or Digital Voice?   

Are you available for:    Full Time        Part Time

Are you seeking:     Home-based    Office-based

When are you available to start?     (e.g. MM/DD/YYYY)

May we contact your previous employers?      

How did you hear about this position?     

Would you also like to submit your resume? If so, do one of the following:

 

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