Front Office Interview Questionnaire Form

Front Office - Patient Coordinator

New Hire Questionaire
Personal Information
Full Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail*
example@example.com
Questions and Details
You must be available to work Saturdays, will this be an issue? If so, why?*
For this position, you will need to be available to cover three locations as needed. Do you have adequate transportation to do so?*
Describe yourself in few words.*
This is a high-paced work environment. How do you deal with and work through stressful situations?*
What are your major skills regarding the job, you have applied for? What skills can you contribute to Complete Dermatology?*
Why did you leave your previous job?*
What was your relationship like with your colleagues at any of your previous places of employment?*
In your own words, if I were to call one of your references how do you think they describe you as an employee?*
What were your daily functions at your previous place of employment?*
What is your preferred salary or hourly pay rate?*
What matters most to you in a job?*
What are your preferred work days and hours? Although most times our last patient is scheduled at 4:30 pm, if the case is a difficult one it could run a little longer. Given we are a medical facility, we do not rush patient care. *
What is the most attractive feature of this job profile? Why Dermatology?*
Why do you want to join our organization? What expressed your interest in Complete Dermatology?*
What are you looking for in your next career? What does your job future look like?*
Where do you see yourself in the next 3-5 years?*
Are you vaccinated, including your booster?*
I have a scenario: A patient comes in insisting that they have an appointment. However, you look at the schedule and notice that they are, in fact, not scheduled. You let the patient know they don’t have an appointment and the they become upset. How do you defuse that situation?*
Anytime you start something new, regardless if it’s general dermatology related or not, you’re bound to make mistakes but it’s my job as a manager to provide you adequate training and support. It’s also my job to provide you feedback. How do you take feedback if I had to bring up a situation with you?*
Date*

MonthDayYear
Date
Please verify that you are human*
Upload Resume Here

Cancelof
Should be Empty:

Front Office - Patient Coordinator

Personal Information

Questions and Details