Interest Form
Please fill out the following information to express your interest in potentially working with Remote Rehab Solutions Inc. now or in the future. If we have a client in your area we will contact you directly.
Full Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred method of communication:
Email
Text
Phone call
Please indicate your professional designation (if applicable):
*
Please Select
Clinical Social Worker
Registered Psychologist
Registered Occupational Therapist
Registered Physiotherapist
Physiotherapy Intern
Physiotherapy Student
Kinesiologist
Therapy Assistant
None of the above
Location (Please indicate the city or town you live in or nearest to)
*
Date of Birth
*
-
Month
-
Day
Year
Date
Years of Experience
*
Do you have a valid license to practice your profession in Alberta? (if applicable)
*
Yes
No
Not applicable
For our therapy assistant, kinesiology, physiotherapy, and occupational therapy positions some travel may be required. Do you have a valid drivers license and access to a reliable vehicle?
*
Yes
No
Not applicable
Please briefly describe your previous experience (and/or attach your resume at the bottom).
*
Why are you interested in this position?
*
What is your ideal work scenario with Remote Rehab Solutions (casual, part time, full time, leadership opportunities, etc.)?
*
Please briefly describe your availability
*
What is the maximum distance you are willing to travel from your residence?
*
How did you hear about Remote Rehab Solutions Inc?
Please Select
Job Advertisement
Linked In
Company Website
Referral
Other
By submitting this form, I hereby acknowledge that the information provided is accurate, and I consent to the collection and storage of my personal data for the purpose of being contacted for physiotherapy job opportunities with Remote Rehab Solutions Inc.
*
I agree
I disagree
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