Application
Personal Information
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Current City and State of Residence
*
Professional Details
What is your primary healthcare profession?
*
Registered Nurse (RN)
Licensed Practical/Vocational Nurse (LPN/LVN)
Certified Nursing Assistant (CNA)
Physical Therapist (PT)
Occupational Therapist (OT)
Radiology Technician
Lead Care Manager (LOCAL CA RESIDENT ONLY)
Engagement Specialist/ Outreach Specialist (LOCAL CA RESIDENT ONLY)
Clinical Liaison Coordinator / LVN-Care Manager (LOCAL CA RESIDENT ONLY)
RN Assessment Case Manager (LOCAL CA RESIDENT ONLY)
Other
Do you have an active and unrestricted license?
*
YES
NO
If yes, list the state(s) where you are licensed:
License Number(s)
How many years of experience do you have in this field?
*
What healthcare settings have you worked in? (check all that apply)
*
Hospitals
Skilled Nursing Facilities
Rehabilitation Centers
Home Health
Hospice
Telehealth
Other
Professional Details
What type of assignment are you interested in?
*
Per Diem
Travel Assignments
Local Contract
Permanent Placement
What is your preferred shift?
*
Please Select
Days
Evenings
Nights
Open to any shift
Which states or regions are you willing to work in?
*
What is your desired hourly pay or salary expectation?
Compliance & Credentialing
Do you have the following documents readily available? (Check all that apply)
*
Resume
Certificates (BLS, ACLS, PALS, etc)
Immunization Records (TB, COVID, Hepatitis B, etc.)
Background Check or Fingerprint Clearance
Work References
You can upload the documents here.
Browse Files
Drag and drop files here
Choose a file
If you do not have them ready, no problem! We will get them at a later time.
Cancel
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Final Steps
How did you hear about Star Nursing?
Please Select
Referral
Job Board (Indeed, ZipRecruiter, etc.)
Social Media
Website
Other
If you selected referral, Who referred you?
If you selected other, please elaborate.
Star Nursing requires all employees to undergo a background check and drug screening as part of the hiring process. Employment is contingent upon passing these screenings. Do you acknowledge and agree to these requirements?
*
Yes
No
Timekeeping & Mobile Device Use
Most facilities require healthcare professionals to clock in and out using a mobile timekeeping system, which may involve using your personal cell phone. This process may require internet or cellular data usage, and standard data rates may apply based on your carrier. Star Nursing is not responsible for any data usage charges incurred.
Do you acknowledge and agree to use mobile timekeeping systems as required by the facilities you are assigned to?
*
Yes, I acknowledge and agree
No, I do not agree
Please verify that you are human
*
Submit
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