OSHPD’s Healthcare Workforce Survey

The information requested on this survey is mandatory, except for the cultural/ethnic background. Completion of the survey helps determine health professionals’ shortages and improves access to patient care.


Licensing Body - Select one

Board of Registered Nursing
Board of Vocational Nursing and Psychiatric Technicians
Physician Assistant Board
Respiratory Care Board

1. Location of Practice:

If working in more than 2 locations, provide information for the 2 locations where you spend the majority of your time. If not currently practicing in a position that requires licensure, skip to Question 2.

1a. Primary Practice Location:

Primary Health Occupation: Check all that apply

Clinical Nurse Specialist
Nurse Anaesthetist
Nurse Midwife Furnishing
Nurse-Midwife
Nurse Practitioner
Nurse Practitioner Furnishing
Physician Assistant
Psychiatric Technician
Psych/Mental Health Nurse
Public Health Nurse Intern
Registered Nurse
Respiratory Care Practitioner
Vocational Nurse


1b. Secondary Practice Location:

Secondary Health Occupation: Check all that apply

None
Clinical Nurse Specialist
Nurse Anaesthetist
Nurse Midwife Furnishing
Nurse-Midwife
Nurse Practitioner
Nurse Practitioner Furnishing
Physician Assistant
Psychiatric Technician
Psych/Mental Health Nurse
Public Health Nurse Intern
Registered Nurse
Respiratory Care Practitioner
Vocational Nurse



2. Educational Background Check only one.

Select highest degree/certification obtained:

Certification (non-degree) Associate Bachelor Master Doctorate Other


  • Year degree/certification was earned:

Postgraduate Training (Years Completed)

0 1 2 3 4 5 6 7 8 9+

3. Gender

Male Female

4. Race or Ethnicity - OPTIONAL (you may select more than one)

Decline to State
African American/Black/African-Born
American Indian/Native American/Alaskan Native
Caucasian/White European/Middle Eastern
Latino/Hispanic (If Latino/Hispanic, please select one of the following)
Central American
Puerto Rican
Cuban
South American
Mexican
Other Hispanic
Asian (If Asian, please select one of the following)
Cambodian
Chinese
Hmong
Indian
Indonesian
Japanese
Korean
Laotian
Malaysian
Pakistani
Singaporean
Thai
Vietnamese
Other Asian
Native Hawaiian/Pacific Islander (If Native Hawaiian/Pacific Islander, please select one of the following)
Fijian
Filipino
Guamanian
Hawaiian
Samoan
Tongan
Other Pacific Islander
Other (not listed above)

5. Languages Spoken – In additional to English, indicate additional languages in which you are fluent

American Sign Language
Amharic
Arabic
Armenian
Cantonese
Croatian
Fijian
Formosan (Amis)
French
French Creole
German
Greek
Gujarati
Hebrew
Hindi
Hmong
Hungarian
Ilocano
Indonesian
Italian
Japanese
Korean
Lao
Mandarin
Mien
Mon-Khmer (Cambodian)
Navajo
Panjabi (Punjabi)
Persian (Farsi)
Polish
Portuguese
Russian
Samoan
Scandinavian/Nordic
Serbian
Spanish
Swahili
Tagalog
Telugu
Thai
Tongan
Turkish
Ukrainian
Urdu
Vietnamese
Xiang Chinese
Yiddish
Yoruba
Other African Languages
Other Chinese
Other Non-English
Other Sign Language
Other (not listed)
Decline to State
None

 

Notice of Collection of Personal Information

Except for the race or ethnicity question, the information requested on this survey is mandatory and must be collected pursuant to Business and Professions Code sections 2717, 2852.5, 3518.1, 3770.1 and 4506. Once aggregated by license category, the information provided will be used to analyze workforce data from licensees for future workforce planning. The information will be provided to the Office of Statewide Health Planning and Development (OSHPD) and may be provided to other governmental agencies or in response to a court order or a subpoena. You have a right of access to records containing personal information unless the records are exempted from disclosure by law. Individuals may obtain information regarding the location of his or her records containing these survey responses by contacting the DCA’s Consumer Information Center at 1625 N Market Blvd., Suite N-112, Sacramento, CA 95834 or (800) 952-5210 (dca@dca.ca.gov).

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