Apply for a Job

Personal Information
Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Alternate Phone
Best Time to Call
Email*
How did you hear about us?*
Other Source*
Please let us know how you heard about us!
SSN*
Date of Birth*
MM slash DD slash YYYY

Resume
Please upload a copy of your resume.
File*
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What position are you applying for?
Job Category
RN Specialty*
LPN/CNA Specialty*
Therapy Specialty*

Emergency Contact Information
Name*
First Last
Relationship to Applicant*
Emergency Contact Number*

Education
Education
School Name Actions
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School Name	Actions

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Certifications

Certifications

Certification	Expiration Date	Actions

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Licenses

Licenses

Licensing State	Issue Date	Expiration Date	Actions

There are no Licenses.

Employee Profile
Are you willing to submit to a drug screen?*
- Yes
- No
Are you willing to submit to a criminal background check?*
- Yes
- No
Do you have any limitations that would restrict you from performing the essential functions of the position for which you are applying?*
- Yes
- No

Experience/Expertise

Experience/Expertise

Specialty	Years of Experience	Actions

There are no Experiences.

Work History
Work History
Facility Actions
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Maximum number of work histories reached.

Facility	Actions

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Application Certification
I hereby certify that all statements made in this application are true to the best of my knowledge. I understand that all falsification or misleading information given in my application may result in the termination of my employment with Precision Healthcare Staffing LLC dba Precision Healthcare Nationalwide TravelStaffing. Furthermore, I understand that my professional conduct and clinical performance is directly related to my ability to be placed on assignments for Precision Healthcare Staffing LLC dba Precision Healthcare Nationalwide TravelStaffing and that I will adhere to all expectations set forth in the employee handbook. I authorization Precision Healthcare Staffing LLC dba Precision Healthcare Nationalwide TravelStaffing to verify the information I have provided, to contact references, and to conduct a criminal background check concerning my qualifications and past employment record. I understand that nothing contained in this application is intended to create an employment contract, either verbal or written, with Precision Healthcare Staffing LLC dba Precision Healthcare Nationalwide TravelStaffing or its clients. Furthermore, I understand that in the event of my employment, it is “at will” and Precision Healthcare Staffing LLC dba Precision Healthcare Nationalwide TravelStaffing or I may terminate my employment at any time with or without notice and with or without cause.
Terms*
- I agree to the terms and conditions
* I acknowledge that I will be legally obligated by the terms of this document by signing, in the provided space and electronically transmitting this document to Precision Healthcare Staffing LLC dba Precision Healthcare Nationalwide TravelStaffing. I agree that Precision Healthcare Staffing LLC dba Precision Healthcare Nationalwide TravelStaffing and I may use electronic means to conduct this transaction and that this document shall be governed and construed by the laws of the State of Nebraska.
Signature*
Date*
MM slash DD slash YYYY
Application ID
Skills Checklist
Once you submit your application by clicking the “Submit Application” button below. You will be immediately redirected to the skills checklist matching your selected specialty from the application. If you need to submit additional skills checklists, you will be provided with a link allowing you to fill out other checklists upon completion of the initial one. Please keep your Application ID (received by email) handy as you will need it to fill out all skills checklists.

Job Application

Step 1 of 11 – Personal Information

Personal Information

Resume

What position are you applying for?

Emergency Contact Information

Education

Certifications

Licenses

Employee Profile

Experience/Expertise

Work History

Application Certification

Skills Checklist