convalescent/nursing/ACFL clinics, physician’s offices, hospice, Facility Patient homes, jails, prisons or detention centers, advise if hired by: Patient’s Guardian 6. Employees and Independent Contractors—Annual Staffing: INDEPENDENT EMPLOYEES CONTRACTORS Professional Classification Type Number of Employees Number of Subcontracted Workers Full Time Part Time Dietician/Nutritionist Infant/Pediatric Care Licensed Counselors Medical Director Medical Marijuana Caregiver Nurse—Practitioner Nurse—Registered (RN) Nurse—General (LPN, LVN) Occupational Therapist Pharmacist Physical Therapist Physician Physician Assistant Psychologist Rehabilitation Therapist Respiratory Therapist Social Worker Speech Therapist X-Ray Technicians Other (describe): INDEPENDENT EMPLOYEES CONTRACTORS Non-Professional Number of Employees Number of Classification Type Subcontracted Workers Full Time Part Time Certified Nursing Assistants (CNA) Homemaker Health Aides Midwives/Doula Nurse Aides Nursing Assistants—Registered (NA/R) Patient Care Assistants Personal and Home Care Aides Social Worker Student Nurses Other (describe):
clinics, physician’s offices, hospice, convalescent/nursing/ACFL homes, jails, prisons or detention centers, advise if hired by: Facility Patient Patient’s Guardian 6. Employees and Independent Contractors—Annual Staffing: Professional Classification Type EMPLOYEES INDEPENDENT CONTRACTORS Number of Employees Number of Subcontracted Workers Full Time Part Time Dietician/Nutritionist Infant/Pediatric Care Licensed Counselors Medical Director Medical Marijuana Caregiver Nurse—Practitioner Nurse—Registered (RN) Nurse—General (LPN, LVN) Occupational Therapist Pharmacist Physical Therapist Physician Physician Assistant Psychologist Rehabilitation Therapist Respiratory Therapist Social Worker Speech Therapist X-Ray Technicians Other (describe): Non-Professional Classification Type EMPLOYEES INDEPENDENT CONTRACTORS Number of Employees Number of Subcontracted Workers Full Time Part Time Certified Nursing Assistants (CNA) Homemaker Health Aides Midwives/Doula Nurse Aides Nursing Assistants—Registered (NA/R) Patient Care Assistants Personal and Home Care Aides Social Worker Student Nurses Other (describe):