Download Forms

Please follow the links located below to download the select forms.

Application	Skills Check Lists
Safety and JCAHO Forms	Forms I-09 and W-04
Direct Deposit Authorization	Employee Time Sheets
Employee Evaluation/Reference	Assignment Evaluation
Group Health Forms

All forms require Adobe Acrobat Reader.

Application

We have several ways for you to apply:

1. Fill out the Online Application directly on this website. You can save your progress and get back to it at a later time.

2. If pressed for time, take advantage of our convenient Quik Contact Form with the option to upload your resume. This will include your name in our Nurse Data Base and gives us the opportunity to contact you to discuss how we can help you best.

3. Contact us via telephone or e-mail to request an application package or to speak to a recruiter.

4. Download the Application below and type the information directly into the opened document on your computer. Then print a copy and fax or mail it back to us. Of course you may also complete the form the old fashion way and fill it in by hand.

Application (download here)

Clinical Competencies/Skills Check Lists

Depending on you clinical specialty our clients require a skills check list to be completed. For your convenience, you can download the most common ones below.

Dialysis	OR
Peds	PACU
PICU	OT
CCU & ICU	OTA
Tele	PT
Tele PCU	RT
ER	OR Tech
L&D	Med Tech
Cath Lab	Rad Tech
GI	CNA
Med Surg	EMT
Psych	Phlebotomist

Policy and Procedure Forms

Also depending on the assignment you might have to complete the standard safety and JCAHO forms. Your recruiter will advise you whether you need to complete this step.

Policy & Procedure Forms (download here)

Homeland Security Form I-09 and IRS Form W-04

Before we can bring you on board as an employee, law requires you to complete the following government forms.

Form I-09 (download here)

Form W-04 (download here)

Direct Deposit Authorization

This Form authorizes us to send payroll credit entries (and appropriate debit and adjustment entries) electronically, or by any other commercially accepted method, to your bank account. This also authorizes the financial institution holding your account to post all such entries. Pay roll funds will be deposited to your account by Fridays after the end of the weekly pay-period.

Direct Deposit Authorization Form (download here)

Employee Time Sheets

You may download a blank weekly Employee Time Records below. Please note that the Time Records are due in our office no later than 10:00 AM PST on the Monday following the reporting period. Please assist us by filling out your time record as neatly as possible using a fine point pen, this record is used to prepare your paycheck and is presented to our client as verification of your hours worked.

Note: Please ensure that you get an authorized signature from a client representative before faxing your time record to us.

Weekly Time Sheets (download here)

Employee Evaluation Form

Please give this form to your administrator or charge nurse before the end of your assignment to evaluate your skills. We will use this form as a reference about your professional abilities and include it in your profile when advertising you for your next assignment.

Employee Evaluation Form (download here)

Assignment Evaluation Form

We would like to know how you liked your travel assignment. Use this form to evaluate the different aspects of your experience. It is a great help for us to improve on our services and to share some of your impressions with other potential candidates going on the same assignment.

Assignment Evaluation Form (download here)

Group Health Plan Enrollment/Change Form

We offer our employees a Group Health, Dental and Vision plan. All employees must fill out this form within the first month of employment to either enroll or decline this benefit. For more information regarding health benefits, please contact our office.

Group Health Enrollment/Change Form (download here)

Dental & Vision Enrollment/Change Form (download here)

Adobe Acrobat Reader

All forms in this section are in the Adobe Acrobat (PDF) format. If you do not currently have Adobe Acrobat, download it here for free first. Simply follow the steps outlined on the adobe website to download and install this free program. Please contact us if you need assistance.