Name *
E-mail Address *
Phone Number with Area Code *
City, State *
1. What Specific Job are you applying for? *
2. Are you able to work overtime, including some weekends? *
I prefer not to
I’ll help out only if I'm asked
As long as it is occasional
Its something I'm used to
Absolutely – You need me I’m there
3. Do you smoke, even occasionally? *
Yes
No
4. Do you think you can give a coworker too much praise? *
Yes
No
It depends on the situation
Only if they deserve it
The more praise, the better
5. What type of waste bothers you the most? *
Paper and Supplies
Human Resources
Time
Money
Rework
6. When you are driving alone, what do you spend most of the time think about? *
Things I will do with my time off
My family , friends, hobbies etc
Work – what happened today
Work - My plans for tomorrow
I unwind, switch gears, just relax
I listen to educational programs
7. What do you do if your boss criticizes you for something you know is right? *
Go with the flow and stay quiet
Mention it but don't worry about it
Make the case and move on if no action
Make the case and don't let it go
Pursue it until it is right
8. How important are rules in managing a company? *
Vital & should be followed exactly
Need to be followed most of the time
Guidelines to follow only if practical
I like to do what is right instead
If there is a better way ignore them
9. Do you enjoy changing people’s minds? *
There’s nothing I enjoy more
Yes most of the time
Only if I feel strongly about it
Not usually
I am usually uncomfortable doing so
10. Are you a good loser? *
No, I hate to lose
Only on Occasion but better if never
I feel the pain, and move on
Losing is part of life’s lessons
Yes I can be a gracious loser
11. Do you ever feel aggressive and challenge people more than you should? *
Yes
No
12. How would you describe an effective employee meeting? *
Everyone is allowed to participate
Everyone knows what they need to do
Everyone gets to share their concerns
Time is allotted for social interaction
Relavent Information is conveyed
13. How many words per minute can you type without errors? *
I can't type
Less than 30
30-40
40-50
50-60
60-70 or more
70 or more
14. How Many years of experience do you have working with physicians ? *
None
1-2 Years
3-5
5-7
7-10
Over 10
15. What is the highest level of education you have achieved? *
High School
High School plus some college
2 -3 year Associates Degree
4 year College Graduate
Masters Degree
Medical, Legal Professional School
Doctorate
16. What Specific Skills or Experience Qualifies you for the Job? Please elaborate. *
17. What do you enjoy doing the most at work? What are you best at? *
18. What areas would you consider yourself an expert? *
19. Describe your most challenging project, the obstacles you had to overcome, how you overcame them ( tools, methods you used ) and the final result you were able to achieve *
What was your annual base salary last year? *
What bonuses or commissions did you earn above your base salary?
