Official SealDepartment of Budget and Management

Supplemental Questionnaire

Last Name
First Name


Please note that your answer on the supplemental questionnaire must correspond to the information that is provided on your resume to receive credit.


Are you licensed by the Maryland Board of Physicians to practice medicine under Maryland State Law?  If so, please attach copy of license to application.

Yes No

Do you possess a current Maryland Controlled Dangerous Substance Registration?

Yes No

Are you Board Certified in Forensic Psychiatry?  Please submit a copy of your certification with your application.

Yes No

Describe your experience at the managerial or supervisory level. Please include name of employer, job title, titles of those you supervised, programs managed, dates of employment, and hours worked per week.  This information must also be reflected in your application or resume. 

If you do not possess experience in this area, put N/A in the box below.

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