Riverside Care of Florida Staffing Intake:
Local, Per Diem & Travel Staffing
Select Your Primary Specialty
*
Please Select
Clinic
ER
Home Health
ICU
L&D
Med-Surg
Oncology
Operating Room
Other
PACU
Pediatric
Pre-Op
Psych
Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Upload Your Resume
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Upload Your Driver's License
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Upload Your Professional License (RN, LPN, CNA, PT, OT, ST, RT, etc)
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Upload Your ACLS (if applicable)
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Upload Your PPD or CXR (within the last 5 years)
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Upload Your Physical/Health Statement
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Upload Your Hepatitis B Vaccine or Titers
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Upload Your Certifications (1) (if applicable)
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Upload Your Certifications (2) (if applicable)
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Please select all states you are licensed to practice in. Select "Compact" if you hold a compact license. Select "N/A" if your profession does not require specific state licensure.
*
N/A
Compact
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Preferred Start Date
*
ASAP
Two Weeks
30 Days
60 Days
Greater Than 2 Months
Residency Status
*
US Citizen
Permanent Resident
Work Permit
Additional Information: (if you work in more than one specialty, please list all here)
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