Staffing Credential & Compliance Document Submission
Submit your professional credentials and compliance certificates for Charisma Healthcare Staffing internal review only—no official record updates until approved.
For credential/compliance review only. Do not upload Social Security cards, government identity documents, I-9/W-4 forms, banking/direct-deposit information, or medical/occupational-health records through this form.
Full Name
*
First Name
Last Name
Email Used for Staffing Account
*
example@example.com
Use Placement ID only when Charisma has issued a documented approved placement/assignment ID. If you are only an applicant/candidate or have not received an approved placement ID, select Application ID and enter the Charisma application/candidate reference provided by Charisma. A WordPress candidate record number by itself is not a Placement ID. Do not infer or invent a Placement ID.
Exact Placement ID or Application ID provided by Charisma
*
Use the exact Application ID (for example, HC- followed by digits) shown in your Charisma staffing application record, or the exact Placement ID issued by Charisma for an approved placement. An old WordPress candidate number, profile number, or reference number is NOT an Application ID or Placement ID. If you do not have the exact ID, contact Charisma Staffing before submitting; do not guess.
Use Placement ID only when Charisma has issued a documented approved placement/assignment ID. If you are only an applicant/candidate or have not received an approved placement ID, select Application ID and enter the Charisma application/candidate reference provided by Charisma. A WordPress candidate record number by itself is not a Placement ID. Do not infer or invent a Placement ID.
Identifier Type
*
Please Select
Placement ID
Application ID
Use the exact Application ID (for example, HC- followed by digits) shown in your Charisma staffing application record, or the exact Placement ID issued by Charisma for an approved placement. An old WordPress candidate number, profile number, or reference number is NOT an Application ID or Placement ID. If you do not have the exact ID, contact Charisma Staffing before submitting; do not guess.
Position/Role
Enter the position on your Charisma staffing application.
Document Type
*
Please Select
CRCST
CIS
CHL
BLS/CPR
State/Professional License
Other Professional Certification
Continuing Education (CE) Certificate
BLS / CPR Card
HIPAA Training Certificate
Bloodborne Pathogens (OSHA) Training Certificate
Infection Control Training Certificate
Skills Checklist / Competency Assessment
Facility Orientation Certificate
High school diploma / GED
Credential/License Number
Issuing Organization
Issue Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Expiration Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Upload Credential/Compliance Document(s) (PDF, JPG, or PNG only, up to 3 files)
*
Upload a File
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Additional Notes
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