Medical Assistant Application
Share your contact details, credentials, experience, and availability to apply for the role.
Contact Information
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
City
*
State
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Credentials
Are you a certified Medical Assistant?
*
Yes
No
In progress
Certification type
Phlebotomy experience
*
Yes
regularly
Some experience
No
Do you currently hold CPR or BLS certification?
*
Yes
No
Willing to obtain
Experience
Years of Medical Assistant Experience
*
Please Select
None
Less than 1
1 to 2
3 to 5
More than 5
Aesthetic or Functional Medicine Experience?
Yes
No
Tell us about a time you noticed something that needed to be done before anyone asked. What did you do?
*
How do you keep yourself organized on a busy day?
*
Tell us about something you had to learn quickly. How did you get up to speed?
*
Most Recent Role
*
Social Media
Social media is a key component of this position, so it is important that you are genuinely interested and excited about contributing to our digital presence.
How interested are you in creating content such as photos and short videos for the clinic?
*
Not interested
1
2
3
4
Very interested
5
1 is Not interested, 5 is Very interested
What content idea would you love to bring to The Alchemy Clinic?
Instagram, TikTok, or portfolio link
Logistics
Earliest available start date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Are you legally authorized to work in the United States?
*
Yes
No
Which days are you available to work?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Scheduling notes
Resume
*
Upload a File
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Cover letter
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How did you hear about this position?
Please Select
Instagram
Indeed
Referral
Clinic website
Other
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