Clearview Dermatology Employment Application Form

**Equal Employment Opportunity** Clearview Dermatology is an Equal Opportunity Employer. We are committed to providing equal employment opportunities to all applicants and employees and prohibit discrimination in all aspects of employment on the basis of any characteristic protected by applicable federal, Massachusetts, or local law. Employment decisions are based on qualifications, merit, and business needs.

Name:* This field is required.

First Name

Last Name

Phone Number:* This field is required.

Area Code

Phone Number

E-mail Address:* This field is required.

Are you currently a board-certified/board-eligible MD or DO, or are you a dermatology resident expected to graduate within the next 12 months?

What position are you applying for?* This field is required.

Medical Assistant

Patient Services

MD/DO

PA/NP

Other

How were you referred to us?* This field is required.

Walk-In

Employee

Indeed

Website

Facebook

Other

Upload Resume/CV:* This field is required.

Drag and drop files here

Select files to upload

Max. file size: 10.0MB

Are you applying to our Central Mass or Greater Boston locations?* This field is required.

Central Mass (Leominster, Gardner & Hudson)

Greater Boston (Lexington)

Both

Please rank your location preferences.* This field is required.

Rank

Leominster

Hudson

Gardner

Lexington

No Preference

Leominster

Hudson

Gardner

Lexington

No Preference

Rank

Are you currently enrolled or planning to enroll in further education or certifications?* This field is required.

Please explain your future schooling plans* This field is required.

Please explain.

Have you applied before?* This field is required.

Yes

Have you worked here before?* This field is required.

Yes

Are you over 18?* This field is required.

Yes

Do you have reliable transportation?* This field is required.

Yes

Other

Are you legally authorized to work in the United States?* This field is required.

Yes

Are you related to a current or former employee here?* This field is required.

If yes, please list the employee's name, and relationship to you. If no, type N/A* This field is required.

Are you looking for full or part time?* This field is required.

Full time (4-5 8-10 hour shifts/week)

Part-time (1-3 shifts/week)

Are you looking for a permanent or seasonal position?* This field is required.

Please explain:* This field is required.

Please check off days of the week you are AVAILABLE to work?* This field is required.

Monday

Tuesday

Wednesday

Thursday

Friday

Are you available the following hours?

Start at 7am

Start at 9am

End at 5pm

End at 6:30pm

No hour restrictions

Other

Please indicate your availability for a phone/virtual interview?* This field is required.

Monday 9am-12pm

Tuesday 9am-12pm

Wednesday 9am-12pm

Thursday 9am-12pm

Friday 9am-12pm

Monday 1-3pm

Tuesday 1-3pm

Wednesday 1-3pm

Thursday 1-3pm

Friday 1-3pm

Other

Please select the best option for a virtual interview?* This field is required.

Facetime

Zoom

Briefly explain what skills/experience you have that would be a good fit for this position?* This field is required.

If offered employment when would you be available to start?* This field is required.

What is your salary range?* This field is required.

From

Equal Employment Opportunity

Clearview Dermatology is an Equal Opportunity Employer. We are committed to providing equal employment opportunities to all applicants and employees and prohibit discrimination in all aspects of employment on the basis of any characteristic protected by applicable federal, Massachusetts, or local law. Employment decisions are based on qualifications, merit, and business needs.

Clearview Dermatology Employment Application Form