Tell me about your Ideal contract!
Please this form and let me know what your looking for and I will contact you shortly after to discuss the oppertunities I have that fit you best!
Name
*
First Name
Last Name
Are you an LPN or RN?
*
RN
LPN
RRT
Other
How Many Years of Experience do you have?
*
Which certifications do you hold?
*
BLS
ACLS
NIHSS
PALS
NRP
TNCC
Other
What type of Facilities/units would you like to work in?
*
Medical Surgical
Emergency Department
ICU
PCU
PACU
NICU
Corrections
Post portum
Labor and Delivery
LTC
Psychiatric
Clinic
Other
Do you have a compact License? if not, please list which states you are licensed in?
*
When are you looking to start?
-
Month
-
Day
Year
Date
In what city and state is your permenent residence?
*
9.How far are you looking to commute away from your residence? (if looking Local travel or travel in the same state)
*
Less than 50 miles
More than 50 miles
willing to go anywhere in the state
willing to go anywhere I am licensed
Other
Where would you like your next contract to be located at?
*
What Shift are you looking to work?
*
Day
Night
1st shift
2nd shift
3rd shift
What is your minimum desired rate? (this question is asked so I don’t waste yourtime with offers below your desired rate)
*
$1,500+ a Week
$2,000+ a Week
$2,500+ a Week
$3,000+ a Week
Do you prefer block scheduling?
*
Yes, but its not a deal breaker
No
Yes, and its a deal breaker
15.When are you usually available to be contacted?
*
How do you prefer to be contacted?
*
Phone
Text
Email
17. Please provide your email or phone number or both?
*
18.Please email me your resume at Maelbass@maximstaffing.com or Upload it here?
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: