Name*
First
Last
Age Specific Care
Proficiency Rating
Frequency Rating
Newborn/Neonate (birth - 30 days) *
Newborn/Neonate (birth - 30 days) proficiency* Newborn/Neonate (birth - 30 days) frequency* Infant (30 days - 1 year) *
Infant (30 days - 1 year) proficiency* Infant (30 days - 1 year) frequency* Toddler (1 - 3 years) *
Toddler (1 - 3 years) proficiency* Toddler (1 - 3 years) frequency* Preschooler (3 - 5 years) *
Preschooler (3 - 5 years) proficiency* Preschooler (3 - 5 years) frequency* School Age Child (5 - 12 years) *
School Age Child (5 - 12 years) proficiency* School Age Child (5 - 12 years) frequency* Adolescents (12 - 18 years) *
Adolescents (12 - 18 years) proficiency* Adolescents (12 - 18 years) frequency* Young Adults (18 - 39 years) *
Young Adults (18 - 39 years) proficiency* Young Adults (18 - 39 years) frequency* Middle Adults (39 - 64 years) *
Middle Adults (39 - 64 years) proficiency* Middle Adults (39 - 64 years) frequency* Older Adults (64+ years) *
Older Adults (64+ years) proficiency* Older Adults (64+ years) frequency* Elderly Adults (over 79+ years) *
Elderly Adults (over 79+ years) proficiency* Elderly Adults (over 79+ years) frequency*
Radiation Therapy Physics
Proficiency Rating
Frequency Rating
Physical property of atoms and nuclei *
Physical property of atoms and nuclei proficiency* Physical property of atoms and nuclei frequency* Basic nuclear transformations *
Basic nuclear transformations proficiency* Basic nuclear transformations frequency* Medical linear accelerators *
Medical linear accelerators proficiency* Medical linear accelerators frequency* Physical properties of dose and exposure *
Physical properties of dose and exposure proficiency* Physical properties of dose and exposure frequency* Radioactive isotopes *
Radioactive isotopes proficiency* Radioactive isotopes frequency* Electron beam therapy *
Electron beam therapy proficiency* Electron beam therapy frequency* IMRT (intensity modulated radiation) *
IMRT (intensity modulated radiation) proficiency* IMRT (intensity modulated radiation) frequency* 3-D conformal radiation therapy *
3-D conformal radiation therapy proficiency* 3-D conformal radiation therapy frequency* Interaction of high energy electrons and x-rays *
Interaction of high energy electrons and x-rays proficiency* Interaction of high energy electrons and x-rays frequency* Photoelectric effect *
Photoelectric effect proficiency* Photoelectric effect frequency* Campton scatter *
Campton scatter proficiency* Campton scatter frequency* Pair production *
Pair production proficiency* Pair production frequency* Dosimetry equipment *
Dosimetry equipment proficiency* Dosimetry equipment frequency* Ion chambers *
Ion chambers proficiency* Ion chambers frequency* Thermoluminescent Dosimetry *
Thermoluminescent Dosimetry proficiency* Thermoluminescent Dosimetry frequency* TG-51 (calibration protocol) *
TG-51 (calibration protocol) proficiency* TG-51 (calibration protocol) frequency* Beam modifiers *
Beam modifiers proficiency* Beam modifiers frequency* Physical wedges *
Physical wedges proficiency* Physical wedges frequency* Dynamic wedges *
Dynamic wedges proficiency* Dynamic wedges frequency* Blocks *
Blocks proficiency* Blocks frequency* Basic principles and applications of CT Scan *
Basic principles and applications of CT Scan proficiency* Basic principles and applications of CT Scan frequency* Basic principles and applications of MRI Machine *
Basic principles and applications of MRI Machine proficiency* Basic principles and applications of MRI Machine frequency* Basic principles and applications of PET Scan *
Basic principles and applications of PET Scan proficiency* Basic principles and applications of PET Scan frequency*
Brachytherapy Procedures
Proficiency Rating
Frequency Rating
Systemic errors *
Systemic errors proficiency* Systemic errors frequency* Random errors *
Random errors proficiency* Random errors frequency* Treatment documentation *
Treatment documentation proficiency* Treatment documentation frequency* Procedure checklists *
Procedure checklists proficiency* Procedure checklists frequency* Application insertion *
Application insertion proficiency* Application insertion frequency* Implant localization and stimulation *
Implant localization and stimulation proficiency* Implant localization and stimulation frequency* Treatment prescription *
Treatment prescription proficiency* Treatment prescription frequency* Intravascular brachytherapy *
Intravascular brachytherapy proficiency* Intravascular brachytherapy frequency* Implant design and evaluation *
Implant design and evaluation proficiency* Implant design and evaluation frequency* Localization *
Localization proficiency* Localization frequency* Computer treatment planning *
Computer treatment planning proficiency* Computer treatment planning frequency* Manual verification of computer calculations *
Manual verification of computer calculations proficiency* Manual verification of computer calculations frequency* *
Patient preparation, setup, and treatment proficiency* Patient preparation, setup, and treatment frequency* Post treatment quality assurance *
Post treatment quality assurance proficiency* Post treatment quality assurance frequency* Emergency Procedures for HDR *
Emergency Procedures for HDR proficiency* Emergency Procedures for HDR frequency* Routine emergency equipment *
Routine emergency equipment proficiency* Routine emergency equipment frequency* Physical plant emergencies *
Physical plant emergencies proficiency* Physical plant emergencies frequency* Minor and major emergencies *
Minor and major emergencies proficiency* Minor and major emergencies frequency* Prostate seed implants - I-125 seeds *
Prostate seed implants - I-125 seeds proficiency* Prostate seed implants - I-125 seeds frequency* Prostate seed implants - P-103 seeds *
Prostate seed implants - P-103 seeds proficiency* Prostate seed implants - P-103 seeds frequency*
Treatment Planning
Proficiency Rating
Frequency Rating
Auxiliary devices (digitizer, plotter) *
Auxiliary devices (digitizer, plotter) proficiency* Auxiliary devices (digitizer, plotter) frequency* Software *
Software proficiency* Software frequency* Quality Assurance *
Quality Assurance proficiency* Quality Assurance frequency*
Special Techniques
Proficiency Rating
Frequency Rating
TBI (total body irradiation) *
TBI (total body irradiation) proficiency* TBI (total body irradiation) frequency* Electron arc therapy *
Electron arc therapy proficiency* Electron arc therapy frequency* Intraoperative electron therapy *
Intraoperative electron therapy proficiency* Intraoperative electron therapy frequency* TSI (total skin irradiation) *
TSI (total skin irradiation) proficiency* TSI (total skin irradiation) frequency* Intraoperative electron therapy *
Intraoperative electron therapy proficiency* Intraoperative electron therapy frequency* SRS (stereotactic radiosurgery) Multileaf collimators *
SRS (stereotactic radiosurgery) Multileaf collimators proficiency* SRS (stereotactic radiosurgery) Multileaf collimators frequency* Data input into treatment planning *
Data input into treatment planning proficiency* Data input into treatment planning frequency* SRT (Stereotactic radiotherapy) *
SRT (Stereotactic radiotherapy) proficiency* SRT (Stereotactic radiotherapy) frequency*
Standards for Treament Plans / Protocols
Proficiency Rating
Frequency Rating
Ensures accurate dose *
Ensures accurate dose proficiency* Ensures accurate dose frequency* Ensures proper patient positioning *
Ensures proper patient positioning proficiency* Ensures proper patient positioning frequency* Ensures proper machine settings *
Ensures proper machine settings proficiency* Ensures proper machine settings frequency* Deviation of normal parameters for equipment *
Deviation of normal parameters for equipment proficiency* Deviation of normal parameters for equipment frequency*
Treatment Aids
Proficiency Rating
Frequency Rating
Field shaping *
Field shaping proficiency* Field shaping frequency* Multileaf collimators *
Multileaf collimators proficiency* Multileaf collimators frequency* Half-value thick blocks *
Half-value thick blocks proficiency* Half-value thick blocks frequency* Gonadal shields *
Gonadal shields proficiency* Gonadal shields frequency* Eye shields *
Eye shields proficiency* Eye shields frequency* Internal shields *
Internal shields proficiency* Internal shields frequency* In vivo Dosimetry *
In vivo Dosimetry proficiency* In vivo Dosimetry frequency* Use of TLD (Thermoluminescent Dosimeters) chips *
Use of TLD (Thermoluminescent Dosimeters) chips proficiency* Use of TLD (Thermoluminescent Dosimeters) chips frequency* Patient positioning *
Patient positioning proficiency* Patient positioning frequency* Body positioning *
Body positioning proficiency* Body positioning frequency* Anatomic landmarks *
Anatomic landmarks proficiency* Anatomic landmarks frequency* Certify your information* I certify that I have provided true and accurate information about my skills and experience to the best of my ability
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