Official SealHuman Resource Services Department

Supplemental Questionnaire

Last Name
First Name

Applicants for this position are required to submit responses to the following supplemental questions.  Your completed responses to the supplemental questionnaire will be evaluated to determine your qualifications and must be completed properly in order to be given full consideration for the next phase in the selection process. Additionally, your responses will also be evaluated and used in the selection process in order to identify the best qualified applicants. 

Responses should be thorough and specific.  A lack of detail and explanation in the supplemental questions and in your application may result in failure or disqualification for this position.  Clarity of expression, content, experience, grammar, spelling and the ability to follow instructions will be considered in the evaluation process.  A resume will not be accepted as a substitute for properly completed responses.

Information provided in your responses to the supplemental questionnaire regarding your employment experiences must also be detailed in the Work Experience section of the application for this recruitment.  Please be sure to list all employers and required information, on your application, especially if you are referencing those employers in your responses to the supplemental questions.

By selecting yes below, you certify your understanding of this statement:

Yes No

Please describe your clinical and managerial experience serving the following multicultural, high-risk populations:

    1. Maternal, child health
    2. Individuals with communicable diseases
    3. Individuals with complex medical and psychosocial needs

How would you evaluate programs and nursing interventions using a health equity lens?


How would you work with your team to ensure successful implementation of a change that was mandated by the department, program or your direct supervisor?


Describe the skills and experience you possess to prioritize and work on multiple projects simultaneously in a fast-paced environment.


What approaches and methods would you employ to successfully lead, manage and supervise a multidisciplinary team and maintain effective work relationships?


Please describe your nursing experience within the last five years in a clinical and/or public setting, which has included at least one year of full-time lead/supervisory experience.


The supplemental questions above were designed to elicit your experience as it relates to the current recruitment in order to identify the best qualified candidates for the position.  Only the most suitably and best qualified candidates will be invited to participate in the oral interviews. 

By selecting yes below, you certify your understanding that all applicants who meet the minimum qualifications are not guaranteed to move forward in the process.   Do you understand the above statement?

Yes No