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Certicode Cancer Registry Specialists

* Required Field


* First Name

Middle Name
* Last Name

Current Address

Address 2

City

* State

Zip

* Email Address

* Preferred Phone

Secondary Phone
* Willing to Travel
* CTR Status
Desired Employment Status
Current Employment Status
Language Fluency
English
Spanish
French

Other

Preferred Contact Method:
Years of Cancer Registry Experience
Years of Healthcare Experience
Experience:
Have you supervised others?
Y N
Ever worked in a central cancer registry?
Y N
Multi Hospital registry experience?
Y N
Experience with pediatric cancer registry?
Y N
Veteran's Affairs/Government Agency Registry experience?
Y N
Worked in ACoS approved cancer program?
Y N
ACOS survey experience?
Y N
Teaching facility experience?
Y N
NCI facility experience?
Y N
Systems

ERS
Impac
Impac: MOSIAQ
Impac: Pre'cis
Oncolog
CNET
Veterans' Affairs/Gov Registry
Rocky Mountain
Eureka
CDC Abstract Plus or Registry Plus

Other:

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Certicode, LLC • 1112 Magnolia Street, Greensboro, NC 27401 • Tel - 336.274.3281