UW Health Sciences Administration Phone Screen Questionnaire

Candidate Name:	Interviewer:
Phone Number: ( )	Email:
Interview Date:	Interview Time:
Position:

Availability:
Are you currently still interested and available to work at the UW?	YES NO
What percent of the time of # of hours / week?	____ Hrs / Week ____ %
Which shifts are you available to work?	Day Evening Night
What locations are you interested in?	UW Campus Western Facility

Salary Range Confirmation: Monthly $_______________ Annually $_______________
Classified Salary Range:	YES NO
Is this range within your expectations?`
Professional Hiring Range:	Notes:
What are your salary requirements?

Minimum Qualification Verification:
Education:
What is the last level of education completed?	HS/GED AA BA/BS MA/MS Less than HS Notes:
If asked, can you provide documentation?	YES NO
Experience:
Tell me how your background matches the requirements for this position?	Meets Exceeds Does not meet Notes:
What interests you about this position?	Notes:
Employment History:
Ask about breaks in employment, “demotions,” etc. in resume that are concerning. Reasons valid?	Notes:
Are the reasons valid?	YES NO

Health Sciences AdMinistration:
Can you tell us about what we do, units that report to HSA, relationship within UW?	YES NO Notes:
If yes, have any questions?	Notes:
Have you worked in an organization that conducts animal research?	YES NO Notes:
How do you feel about using animals in research settings?	Positive Neutral Negative Notes:
Do you know anyone who works in HSA?	YES NO If yes, name of employee: Notes:

sERVICE oRIENTATION:
Can you tell me about a time when you provided excellent customer service by going beyond your primary job responsibilities? OR Have you had the opportunity to develop and ‘roll out’ or introduce a new system, program, or product?	Criteria: Response demonstrates candidate went out of his / her way to help the customer. Response describes specific candidate behaviors and demonstrates – Active listening with the customer. Candidate looked for ways to provide/introduce service. Candidate did not pass off the problem to someone else; candidate owned the task/acquired data, materials. Candidate sought to put the customer at ease and/or to calm him/her. Planned, implemented, collaborated process. Excellent Response Satisfactory Response (some of above) Unsatisfactory Response (none of above)	Notes:

-OR-
InterpersonAL sKILLS
Describe a situation when you encountered a frustrated customer or co-worker. How did you handle the situation? What was the outcome?	Criteria: Candidate describes positive outcome encounter OR reflective self-evaluation, i.e. additional measure that could have been taken to improve the situation Candidate’s response does not include assigning blame or criticism. Candidate’s example demonstrates: Use of “I” statements. An Empathetic role. Asking clarifying questions. Taking ownership of the problem and seeking resolution to closure. Establishing common ground. Excellent Response Satisfactory Response Unsatisfactory Response	Notes:

Do you have any questions for us?	Notes:

Availability to Interview If you are selected for an in-person interview how soon are you available to come in?	Now 1 Week 2 Weeks Notes:
Contact Information Verify all contact information on the resume	Current and accurate Notes:

General Keywords/Themes:	Notes:
Ownership
Ambiguity
Roles/Responsibilities/Reporting
Liaison
Relationships
Authority
Developing jobs/process
Soliciting/utilizing feedback
Strategic Planning
Efficiencies
Collaboration
Compliance
Electronic vs. Verbal Communication

Key Position-Related Terms:	Notes: Customize to position, specific software, or program acronyms