Are you seeking employment in the healthcare industry? Quality Medical Staffing Agency, LLC could be your vehicle towards career and professional growth.
Time and 1/2 for traditional and non-traditional holidays
Facility and Nurse Recruiting Bonuses
24-hour Support
Cancellation Compensation
Please submit an application to express your intent in being included in our network of health care professionals:
First Name
Last Name
Home Phone
Cell Phone
Email
Street Address
City
State
Zip Code
Work Objective
Date Available to Start
Profession
Specialty
Years of Experience at
your current profession
Would you like to Travel?
Places you are willing to travel
Is your professional license valid in which state(s)
Certifications
Other:
Have you work at your current profession the last 12 months?
Are you employed now?
Do you have management experience?
How many months?
Do you have supervisory experience?
How many months?
Do you have charge nurse experience?
How many months?
Have you work as travel nurse?
How many months?
Have you work on these units before?
Medical/Surgical
How many months?
Critical Care/Emergency Room
How many months?
Nursery/Neonatal/Pediatric
How many months?
Obstetrical
How many months?
Operating Room
How many months?
PACU
How many months?
Psychiatric
How many months?
Telemetry/PC
How many months?
Long Term Care
How many months?
Homecare
How many months?
Hospice
How many months?
Doctors Office (Clinics)
How many months?
Shift Preference
Terms of Assignments
Education (College)
School
Location
Degree
Did you graduate?
Education (Vocational)
Education (High School)
Has your professional license or certification ever been investigated or suspended?
Have you ever been convicted of a crime other than a minor traffic violation?
Have you ever been named as a defendant in a professional liability action?
Can you submit verification of your legal right to work in the United States?
If you will be employed on a visa, please specify the type of visa.
Person to notify just in case of emergency
Name
Relationship
Phone
Alternate Phone
Employment History (May we contact your present employer?)
Employer (most current)
Department
Dates
Comments
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Employer
Department
Dates
Comments
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Employer
Department
Dates
Comments
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This is not an offer of employment, but we will contact you upon receiving your electronic data. We will match your experience with our clients needs and we will call you within 24-72 hours. If you have any questions, please call us.