Job Description Worksheet At (practice), our Mission is (Mission). We recognize that this Mission can only be realized through a team of professionals who are dedicated to upholding our values and creating a culture that permeates every position on our staff. This questionnaire has been designed to assist us in developing job descriptions for each position on our team. We would greatly appreciate your help in creating these important documents. Answer all questions below in regards to the position that you currently hold in our practice. Name:_____________________________________
Date:__________________________________
Position:___________________________________
Hire Date:______________________________
1. What do you feel are the minimum experience requirements for this position (type and length): _______________________________________________________________________________________
2. What do you feel are the minimum education requirements for this position (type and length): _______________________________________________________________________________________
3. What method do you use to interact with coworkers and clients (value should total 100%): a. Face-to-Face Discussions _______________% b. Telephone Conversations _______________% c. Email Communications _______________% d. Other:_______________________ _______________% Total: 100% 4. How do you spend your time in physical activities (value should total 100%): a. Sitting, in chair or on floor _______________% b. Standing, while performing duties _______________% c. Walking, short or long distances _______________% d. Lifting, up to 30 lbs without assistance _______________% e. Reaching, vertical or horizontal _______________% f. Kneeling/Squatting/Bending Over _______________% g. Climbing Stairs/Ladders _______________% h. Other:________________________ _______________% i. Other:________________________ _______________% Total: 100% 5. What percent of the time are you exposed to the following elements in a typical work day? a. Noise: (value does NOT need to total 100%) i. Low Noise _______________% ii. Moderate Noise _______________% iii. High Noise _______________%
Job Description Worksheet, Page 2 b. Unpleasant or potentially Hazardous Materials: (value does NOT need to total 100%) i. ii. iii. iv. v. vi.
Blood, Vomit, Feces, Urine Anesthetic Gases Cleaning Materials Medical Sharps Zoonotic Disease Other:______________________
_______________% _______________% _______________% _______________% _______________% _______________%
6. List the Tools and Technology that you interact with during your normal course of work: (ie. computer, phone, operating software, laboratory or office equipment, etc.) ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________
7. List the top 5 tasks that you perform most often in your normal course of work: i. __________________________________________________________ ii. __________________________________________________________ iii. __________________________________________________________ iv. __________________________________________________________ v. __________________________________________________________
8. List 5 more tasks that you perform less often: i. __________________________________________________________ ii. __________________________________________________________ iii. __________________________________________________________ iv. __________________________________________________________ v. __________________________________________________________
9. List 5 more tasks that you only perform only occasionally: i. __________________________________________________________ ii. __________________________________________________________ iii. __________________________________________________________ iv. __________________________________________________________ v. __________________________________________________________ Thank you for your participation in this important process. We sincerely appreciate your input!
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