Nurse Availability — August 2026 through December 2026
Submit your standing weekly availability first, then list any known unavailable dates for Aug–Dec 2026 (your latest submission will replace prior ones).
Nurse Information
Full Name
*
First Name
Last Name
Credential
*
Please Select
RN
LPN
RN and LPN (dual)
Mobile Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Home ZIP Code
*
Employment Status with AccuCare
*
Per Diem
Part-Time
Full-Time
Not yet assigned / new hire
Current Assignment
Are you currently assigned to a case?
*
Yes
No
Current case / patient initials or KanTime case name
Standing Weekly Availability
Monday availability
*
Day (7:00 AM – 3:00 PM)
School Hours (7:00 AM – 3:00 PM, school-based case)
Evening (3:00 PM – 11:00 PM)
Overnight (11:00 PM – 7:00 AM)
12-Hour Day (7:00 AM – 7:00 PM)
12-Hour Night (7:00 PM – 7:00 AM)
Not available Monday
Tuesday availability
*
Day (7:00 AM – 3:00 PM)
School Hours (7:00 AM – 3:00 PM, school-based case)
Evening (3:00 PM – 11:00 PM)
Overnight (11:00 PM – 7:00 AM)
12-Hour Day (7:00 AM – 7:00 PM)
12-Hour Night (7:00 PM – 7:00 AM)
Not available Tuesday
Wednesday availability
*
Day (7:00 AM – 3:00 PM)
School Hours (7:00 AM – 3:00 PM, school-based case)
Evening (3:00 PM – 11:00 PM)
Overnight (11:00 PM – 7:00 AM)
12-Hour Day (7:00 AM – 7:00 PM)
12-Hour Night (7:00 PM – 7:00 AM)
Not available Wednesday
Thursday availability
*
Day (7:00 AM – 3:00 PM)
School Hours (7:00 AM – 3:00 PM, school-based case)
Evening (3:00 PM – 11:00 PM)
Overnight (11:00 PM – 7:00 AM)
12-Hour Day (7:00 AM – 7:00 PM)
12-Hour Night (7:00 PM – 7:00 AM)
Not available Thursday
Friday availability
*
Day (7:00 AM – 3:00 PM)
School Hours (7:00 AM – 3:00 PM, school-based case)
Evening (3:00 PM – 11:00 PM)
Overnight (11:00 PM – 7:00 AM)
12-Hour Day (7:00 AM – 7:00 PM)
12-Hour Night (7:00 PM – 7:00 AM)
Not available Friday
Saturday availability
*
Day (7:00 AM – 3:00 PM)
School Hours (7:00 AM – 3:00 PM, school-based case)
Evening (3:00 PM – 11:00 PM)
Overnight (11:00 PM – 7:00 AM)
12-Hour Day (7:00 AM – 7:00 PM)
12-Hour Night (7:00 PM – 7:00 AM)
Not available Saturday
Sunday availability
*
Day (7:00 AM – 3:00 PM)
School Hours (7:00 AM – 3:00 PM, school-based case)
Evening (3:00 PM – 11:00 PM)
Overnight (11:00 PM – 7:00 AM)
12-Hour Day (7:00 AM – 7:00 PM)
12-Hour Night (7:00 PM – 7:00 AM)
Not available Sunday
Total hours per week you WANT to work
*
Please Select
Up to 8 hours
9–16 hours
17–24 hours
25–32 hours
33–40 hours
More than 40 hours
Maximum hours per week you are WILLING to work
*
Please Select
Up to 8 hours
9–16 hours
17–24 hours
25–32 hours
33–40 hours
More than 40 hours
Case Type and Travel
Which case settings are you available for?
*
Home / private duty
School-based
School transport (bus)
Community / outings
Any of the above
Which counties are you willing to work in?
*
Rockland
Westchester
Orange
Putnam
Dutchess
Sullivan
Ulster
Bronx
Nassau
Suffolk
Other (see notes)
Maximum one-way travel distance from home
*
Please Select
Up to 10 miles
Up to 20 miles
Up to 30 miles
Up to 45 miles
More than 45 miles
Do you have reliable transportation and a valid driver's license?
*
Yes
No — I use public transportation
No
Holiday Availability (2026)
Holiday availability
*
Labor Day — Monday, September 7, 2026
Columbus Day — Monday, October 12, 2026
Veterans Day — Wednesday, November 11, 2026
Thanksgiving — Thursday, November 26, 2026
Day after Thanksgiving — Friday, November 27, 2026
Christmas Eve — Thursday, December 24, 2026
Christmas Day — Friday, December 25, 2026
New Year's Eve — Thursday, December 31, 2026
I am not available for any holiday shifts
Labor Day availability
Available
Not available
Prefer not to be scheduled
Columbus Day availability
Available
Not available
Prefer not to be scheduled
Veterans Day availability
Available
Not available
Prefer not to be scheduled
Thanksgiving availability
Available
Not available
Prefer not to be scheduled
Day after Thanksgiving availability
Available
Not available
Prefer not to be scheduled
Christmas Eve availability
Available
Not available
Prefer not to be scheduled
Christmas Day availability
Available
Not available
Prefer not to be scheduled
New Year's Eve availability
Available
Not available
Prefer not to be scheduled
Known Unavailable Dates
Do you have any planned time off, vacation, or other known unavailable dates between now and December 31, 2026?
*
Yes
No
List your known unavailable dates
Additional Notes
Are there any recurring commitments that limit your availability?
Anything else Scheduling should know about your availability?
Acknowledgment
Acknowledgment
*
I acknowledge that the availability information I provided is accurate and complete to the best of my knowledge, and I understand that changes may affect staffing assignments.
Signature
*
Date of Submission
*
-
Month
-
Day
Year
Date
Submit
Submit
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