Chiropractic Assistant Questionaire

Address: *

Educational qualifications, including; course, where you studied and when you graduated: *

(including current study and when you will graduate)

Do you have any massage experience and if so please describe:

Previous work history (including your job title and responsibilities): *

EMPLOYMENT

What hours do you currently work and if so how long do you plan to continue this work: *

What days and times are you available to work: *

Our current opening hours are Monday to Friday 7.30 am - 7.45 pm, Saturday 8 am – 2.30 pm and Sunday 8 am - 1 pm.

Do you have personal commitments which may limit your work availability, if so, when:

What inspired you to apply for this position: *

What other career aspirations do you have: *

SUPERVISION AND TRAINING

What advantages and benefits do you see in working as part of a team: *

What disadvantages do you see: *

Describe your ideal job: *

What is Chiropractic: *

What is Osteopathy: *

Have you been to a Chiropractor or Osteopath before, if so, what was your experience like:

Do you exercise regularly and if so what type of exercises and how often: *

How would you describe your general health and nutritional status: *

GOALS (Employment)

What are your short term goals: *

What are your long term goals: *

What are your life goals: *

List the 5 most important things in your life in order of priority: *

List your 5 most important core values (What characteristics of your personality and of those around you are important to you): *

Are there any areas in which you feel you need to improve your skills: *

In what ways will you grow and benefit from working at this clinic: *

In what ways will this clinic grow or benefit from having employed you: *

Do you have any questions?:

What other information do you feel might be important to us: