Talk to an Advisor Application

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

Please enter a valid phone number.

4

What best describes you?* This field is required.Choose all that apply

I'm currently a Travel Nurse

I'm about to start my first assignment

I'm a Travel Healthcare Professional but not a Nurse

I'm a Staff Nurse

Other

6

Age* This field is required.

7

Marital Status* This field is required.

8

After paying my monthly expenses, I could comfortably save $1,500 per month to invest for retirement and my other goals.* This field is required.

YESNO

9

My annual Taxable and Stipend income is...* This field is required.

Enter your estimated annual taxable income

Enter your estimated annual tax-free stipend income

10

Please Review our Fees

11

If you agree that we can help you in a meaningful way, will your budget allow you to pay our stated fees above?* This field is required.*Please note that we only provide tax services to ongoing clients - no tax-only service

YESNO

12

Where did you hear about us?* This field is required.Choose all that apply

Travel Nurse Webinar

Instagram

Facebook

Firm Website

The Gypsy Nurse

Other Nurse Referral