Leaders in Dialysis Staffing
1-800-554-2230 or Apply Online Now!

Download Forms

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

ApplicationSkills Check Lists/Testing
Employee HandbookIRS Form W-04
Direct Deposit AuthorizationEmployee Time Sheets
HepB Refusal & Varicella VerificationAssignment Evaluation
Group Health Forms

All forms require Adobe Acrobat Reader.


We have several ways for you to apply:

1. 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.

2. You may also fill out the Online Application directly on this website.

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 PDF 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)

Online Skills Checklists and Competencies (Required)

1. Depending on your clinical specialty our clients require at minimum a skills check list for you to be considered.

2. Before you start your first assignment, you are required to complete competency assessments including the annual educational exam

Please click HERE to be guided through the online process, you can save your work and get back to it at any time.

PLEASE NOTE: Some of our clients have their own company specific policies including necessary lab work and certification requirements. Your recruiter will inform you of what is needed.

Employee Handbook and General Orientation (Required for Travel/Per Diem)

Welcome to our team! This handbook will inform you of our policies and procedures. Take a moment to review it, you will find lots of useful information within it. Please print and sign the acknowledge form and fax it back to us prior to your first assignment.

Employee Handbook (download here)

Form W-04 (Required for Travel/Per Diem)

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

Form W-4 (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. Payroll 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)

HepB Refusal & Varicella Verification

Depending on your personal situation, you might be asked to fill out one of these forms. For your convenience we have added them below:

HepB Refusal Form (download here)

Varicella Verification 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.

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