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The skills checklist, required by hospital hiring managers, is an important tool we use to help match you to an ideal assignment. This self-assessment form gives us an overview of your nursing experience and proficiencies so our recruiters are better able to find the positions that suit you. Select the appropriate checklist below and submit your completed form to us with one simple click. If your specialty is not listed below, or if you need additional information or assistance, please contact your local O'Grady Peyton International representative.

Return to the full Skills Checklist page

Phlebotomy Skills Checklist

Denotes required field

This profile is for use by healthcare professionals in this discipline and specialty.  It will not be a determining factor for the program.
Please enter your full legal name as it appears on your Passport.
First Name* Middle Name Last Name*
E-Mail Address* Phone Number*
(Country Code - Area Code - Local)
1. No experience, requires education, training and supervision
2. Intermittent experience; may need support or supervision
3. Proficient; consistent experience, independent
4. Expert level; can teach/supervise others
1 2 3 4
Acute Setting
Free Standing Lab
Reference Lab
1 2 3 4
Adult Venipuncture
Arterial Draw
Bleeding Time
Blood Alcohol Collection
Blood Culture Collection
Butterfly Draw
Centrifuge Operation
Dermal Stick (Finger/Heel)
Drug Screening Collection
Pediatric Venipuncture
PPE Equipment (Gloves/Mask, etc.)
Tube Types and Usage
1 2 3 4
Other: Specify
Other: Specify
1 2 3 4
School Age
Young/Middle Adults
Older Adults/Geriatrics
CERTIFICATIONS (Current at time of completing this form)
Cert. Phlebotomy Technician (CBT-ASCP)
Other: Specify
Other: Specify
Phlebotomy Skills Checklist, version 3

I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. Falsification of any information provided, will result in being ineligible to travel with AMN. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.
O'Grady Peyton International staffs nursing jobs for individuals wanting to work in the United States. We staff travel nurses domestically and fill long-term nursing and allied health assignments for international providers.
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