COMPETENCY ASSESSMENT CHECKLIST Adult Immunization Administration - vaccines 2026

1. Click ‘Get Form’ to open the COMPETENCY ASSESSMENT CHECKLIST in the editor.
2. Begin by entering the facility name, position title, trainee name, assessment start date, and completion date in the designated fields at the top of the form.
3. Proceed to each competency section. For each skill listed, assess your experience level using the self-assessment scale (1=Experienced, 2=Needs Practice/Assistance, 3=Never Done).
4. In the 'Orientation' column, have your preceptor date and initial next to each competency as you complete your training.
5. For validation of competency, document evaluation methods used (e.g., written test or demonstration) along with dates and initials in the respective columns.
6. Utilize comment sections for any additional notes or observations relevant to each competency area.

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