Phs 1813 Form PDF Details

Are you in the process of filing a Professional & Cultural History Summary (PCHS) form, otherwise known as “Phs 1813”? It's an important document that showcases your professional and cultural experiences to employers. Filing this form can be complicated, but with the right guidance it doesn't have to be! In this blog post we will go over the basics of completing your PCHS form properly so you can showcase yourself in a positive light while avoiding any common pitfalls associated with preparing Phs 1813.

QuestionAnswer
Form NamePhs 1813 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesWootton, Exp, OMB, phs 1813

Form Preview Example

PHS-1813

Rev. 8/10

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Commissioned Corps of the United States Public Health Service

FORM APPROVED:

OMB No. 0937-0025

Exp. Date: 08/31/2013

Office of Commissioned Corps Operations

Division of Commissioned Corps Assignments

1101 Wootton Parkway, Suite 100

Rockville, MD 20852

REFERENCE REQUEST FOR APPLICANTS TO THE

COMMISSIONED CORPS OF THE U.S. PUBLIC HEALTH SERVICE

To be completed by the applicant:

Applicant’s Name (Last, First, Middle Initial)

If the reference knows you -- the Commissiond Corps of the U.S. Public Health Service applicant -- by any other name, e.g., maiden name, please indicate that name here:

Only other names the applicant has used.

Your name has been given as a reference by the individual identified above who has applied for appointment to the Commissioned Corps of the United States Public Health Service.

We would appreciate your frank and objective consideration of the requested information. To help us determine whether this person is loyal, trustworthy, and of good character, we ask that you answer all questions on the front and back of this form as fully and specifically as you can. The information you provide will be disclosed to the person identified above if he or she should so request.

The promptness of your reply will aid us greatly in our evaluation of this applicant. The information furnished by former supervisors, employers, or college deans with the same or related background provides valuable information for use in evaluating applicants.

Office of Commissioned Corps Operations

1. PERIOD OF ASSOCIATION

2. PROFESSIONAL RELATIONSHIP TO APPLICANT (CHECK APPROPRIATE BOXES.)

 

 

 

 

 

 

From

To

EMPLOYER

TEACHER

FACULTY ADVISOR

 

 

 

 

 

 

 

 

(MM/YYYY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SUPERVISOR

DEAN

OTHER (SPECIFY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.EVALUATION OF APPLICANT (PROVIDE ANY DETAILS IN SECTION 7.)

ELEMENTS

OUTSTANDING

THANBETTER AVERAGE

AVERAGE

AVERAGEBELOW

FORBASISNO JUDGMENT

ELEMENTS

PRODUCTIVITY

 

 

 

 

 

ABILITY TO WORK WITH AND FOR OTHERS

ABILITY TO WORK INDEPENDENTLY

 

 

 

 

 

FLEXIBILITY -- ADAPTABILITY

INITIATIVE

 

 

 

 

 

ABILITY TO SOLVE PROBLEMS --

 

 

 

 

 

 

APPLICATION OF SKILLS AND KNOWLEDGE

 

 

 

 

 

RESOURCEFULNESS

 

 

 

 

 

 

CAPACITY FOR DEVELOPMENT

 

 

 

 

 

ORIGINALITY

ATTENDANCE

 

 

 

 

 

JUDGMENT

DEPENDABILITY IN CARRYING OUT

 

 

 

 

 

ABILITY TO COMMUNICATE (ORAL/WRITTEN)

 

 

 

 

 

 

ASSIGNMENTS

 

 

 

 

 

SUPERVISORY ABILITY

 

 

 

 

 

 

 

 

 

 

 

 

 

OUTSTANDING

BETTER THAN AVERAGE

AVERAGE

BELOW AVERAGE

NO BASIS FOR JUDGMENT

4.APPLICANT IS BEST SUITED FOR WHAT SPECIALIZATION, FIELD, OR POSITION

5.DO YOU KNOW OF ANY LIMITATIONS OR OTHER INFORMATION WHICH MIGHT IMPACT ON THE EFFECTIVENESS OR STABILITY OF THIS PERSON? (Training, Personality, Emotional, Ethical)

NO

YES (Give Details in this Space)

(Continue on reverse side)

PSC Graphics (301) 443-1090 EF

6.WOULD YOU BE WILLING TO EMPLOY OR RE-EMPLOY THIS PERSON IF YOU HAD AN OPENING REQUIRING THE GENERAL PROFESSIONAL LEVEL AND PROFESSION OF THIS INDIVIDUAL?

YES (IN WHAT CAPACITY?)

NO (GIVE REASONS)

7. COMMENTS (Please use this space to supply any further information, comments from section 3 and/or evaluation.)

8.SIGNATURE

9.NAME (Type or Print)

12.INSTITUTION OR FIRM ADDRESS (Include ZIP Code) (Do not attach business cards)

10. TITLE OR POSITION

11. DATE

Telephone No. (

)

Ext.

PHS-1813 (BACK) Rev.8/10

How to Edit Phs 1813 Form Online for Free

Whenever you intend to fill out ais de minimis waiver, you won't need to download and install any software - just try using our PDF editor. The tool is continually upgraded by our team, receiving additional functions and growing to be a lot more convenient. This is what you would want to do to get started:

Step 1: First, access the editor by pressing the "Get Form Button" in the top section of this site.

Step 2: As you open the file editor, you'll see the document made ready to be filled out. Aside from filling in various blank fields, you can also do some other actions with the file, such as putting on custom words, modifying the original textual content, inserting graphics, placing your signature to the form, and much more.

It is straightforward to fill out the form using this detailed tutorial! Here's what you have to do:

1. When filling in the ais de minimis waiver, be certain to complete all of the necessary fields in its relevant part. This will help facilitate the work, enabling your details to be processed promptly and accurately.

Step # 1 in completing phs 1813

2. Once your current task is complete, take the next step – fill out all of these fields - PERIOD OF ASSOCIATION, PROFESSIONAL RELATIONSHIP TO, From, MMYYYY, EMPLOYER, TEACHER, FACULTY ADVISOR, SUPERVISOR, DEAN, OTHER SPECIFY, EVALUATION OF APPLICANT PROVIDE, G N D N A T S T U O, N A H T R E T T E B, E G A R E V A, and E G A R E V A with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Completing part 2 in phs 1813

3. This third step should also be quite straightforward, PROFESSION OF THIS INDIVIDUAL, YES IN WHAT CAPACITY, NO GIVE REASONS, and COMMENTS Please use this space to - all these fields must be filled out here.

Simple tips to fill out phs 1813 stage 3

Be very careful while filling out NO GIVE REASONS and YES IN WHAT CAPACITY, because this is the section in which a lot of people make some mistakes.

4. Now start working on this fourth segment! Here you'll get these SIGNATURE, INSTITUTION OR FIRM ADDRESS, cards, NAME Type or Print, TITLE OR POSITION, DATE, Telephone No, Ext, and PHS BACK Rev empty form fields to do.

phs 1813 completion process clarified (portion 4)

Step 3: Check that your details are accurate and just click "Done" to proceed further. Join FormsPal now and instantly get access to ais de minimis waiver, available for download. Each and every modification made is handily kept , enabling you to modify the document at a later time when required. We do not share or sell the details that you use whenever working with forms at our website.