RADIATION SKILLS CHECKLIST
Name:
When completing this ckecklist, please indicate your level of proficiency in each area according to the scale below. Place a check mark in box which best describes your expertiese with each skill.

The scale is as follows:
1. Not performed   2. Intermitten experience   3. Very experienced.
Accelerators
  1. AECL Therac 18   1 2 3
  2. AECL 45   1 2 3
  3. AECL 20 MeV   1 2 3
  4. AECL 6 MeV   1 2 3
  5. Toshiba LMR 15   1 2 3
  6. Toshiba LMR 4   1 2 3
  7. Varian 4/80   1 2 3
  8. Varian 4 MeV   1 2 3
  9. Varian 12 MeV   1 2 3
  10. Varian 18 MeV   1 2 3
  11. Varian 21 Mev   1 2 3
  12. Varian 6/100   1 2 3
  13. Varian 1800   1 2 3
  14. Varian 2500   1 2 3
  15. Varian 35 MeV   1 2 3
  16. Varian 2100C   1 2 3
  17. Philips SL 75/20   1 2 3
  18. Philips 75/5   1 2 3
  19. Siemens 8MeV   1 2 3
  20. Siemens 12 MeV   1 2 3
  21. Siemens Mevatron 20   1 2 3
  22. Siemens Mevatron 67   1 2 3
  23. Siemens Mevatron 74   1 2 3
  24. Siemens Mevatron 77   1 2 3
  25. Siemens 60   1 2 3
  26. Siemens 6700   1 2 3
  27. Siemens KD   1 2 3
  28. Simens 6/10 MeB   1 2 3
  29. Siemens 6740   1 2 3
  30. Therapl 4 MeV   1 2 3
  31. Microtron   1 2 3
  32. CTM System   1 2 3
  33. Sagitaire 50 MeV   1 2 3
  34. SMH 4 MeV   1 2 3
  35. Mitsubishi   1 2 3
  36. CGR Saturn 20   1 2 3
  37. Betatron   1 2 3
  38. ATC-6   1 2 3
  39. Orion 4 MeV   1 2 3
Cobalt Machines
  1. AECL Eldorado 6   1 2 3
  2. AECL Eldorado 8   1 2 3
  3. AECL Theratron 780   1 2 3
  4. Picker V-8   1 2 3
  5. Picker C-9   1 2 3
  6. Siemens Gamatron 8   1 2 3
  7. AEC: Cesium Telecurl   1 2 3
  8. RCR 120 C-3   1 2 3
  9. CGR   1 2 3
  10. TEM   1 2 3
  11. Phoenix   1 2 3
  12. Toshiba Isocentric   1 2 3
  13. Philips   1 2 3
  14. Gamma Gel   1 2 3
Computers
  1. Capintec   1 2 3
  2. Adao   1 2 3
  3. CMS Modulex   1 2 3
  4. TAD 8   1 2 3
  5. Varian RO7   1 2 3
  6. HP 9820A   1 2 3
  7. Varian RMS   1 2 3
  8. HP 9845   1 2 3
  9. GE R/T Plan   1 2 3
  10. HP 9836   1 2 3
  11. AECL TP II   1 2 3
  12. HP 85A   1 2 3
  13. AECL Therapian   1 2 3
  14. HP 9830   1 2 3
  15. TADPLANS-6   1 2 3
  16. Siemens   1 2 3
  17. Atronix PC 12   1 2 3
  18. PDP 11/45   1 2 3
  19. Toshiba   1 2 3
  20. P-Z Sim   1 2 3
  21. VAX 11/780   1 2 3
  22. IBC 270/165   1 2 3
  23. Multidata   1 2 3
  24. TRS 80   1 2 3
  25. ATC   1 2 3
  26. Picker Synerplan   1 2 3
  27. IMPAC   1 2 3
  28. Apple II   1 2 3
  29. ROCS   1 2 3
  30. DG S-250   1 2 3
  31. CMS   1 2 3
Hyperthermia
  1. BSD   1 2 3
  2. Clinitherm   1 2 3
Other
  1. Gamma Med HDR   1 2 3
  2. Nucletron HDR   1 2 3
  3. Cyckitrib   1 2 3
  4. Huestis Block Cutter   1 2 3
  5. Portal Cast Block Cutter   1 2 3
  6. Totate Equeipment   1 2 3
  7. Do simulations   1 2 3
  8. Make Custom Molds   1 2 3
Simulators
  1. Toshiba   1 2 3
  2. AECL Therasim 750   1 2 3
  3. ATC   1 2 3
  4. Cascade   1 2 3
  5. Kermath   1 2 3
  6. Philips   1 2 3
  7. Picker Ther-X   1 2 3
  8. Ximatron   1 2 3
  9. Theratron   1 2 3
  10. Oldeleft   1 2 3
  11. CGR’HRL RAD II   1 2 3
Superficial Orthovoltage
  1. General Electric 120KVP   1 2 3
  2. Keleket 250   1 2 3
  3. Maxitron 300   1 2 3
  4. Picker 100 KVP   1 2 3
  5. Siemens   1 2 3
  6. Philips RT-250   1 2 3
  7. Philips RT-100   1 2 3
  8. Philips 250 KV   1 2 3
  9. Philips TR-50   1 2 3
  10. Bucky   1 2 3
  11. Westinghouse 230 LVP   1 2 3
  12. GE Maximar 250   1 2 3
  13. Universal   1 2 3
  14. Picker Vanguard 250 KV   1 2 3
  15. Picker Cesium 137   1 2 3
The information I have given is true and accurate to the best of my knowledge. Please sign and date below.
SIGNATURE: (Last 4 digits of your SSN)    Reenter your last 4 digits of your SSN:   DATE:

  
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