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Applicant Profile Form

UltraStaff's Assignments & Employment Opportunites

For personal assistance 24 hours a day, seven days a week please call 713.522.7100.
I am searching for: Per Diem Opportunities
Temp-To-Hire Opportunities
Direct Hire Opportunities
Available Start Date:
Classification: RN (Registered Nurse)
LVN (Licensed Vocational Nurse)
C.N.A. (Certified Nurse Aide)
COTA (Certified Occupational Therapist Assistant)
LPTA (Licensed Physical Therapist Assistant)
MA (Medical Assistant)
MSW (Medical Social Worker)
NP (Nurse Practitioner)
OR Technician
OT (Occupational Therapist)
Phlebotomist
PT (Physical Therapist)
Psychiatric Technician
Radiology Technologist
Registered Dietitian
Certified Respiratory Therapist
Registered Respiratory Therapist
SLP (Speech & Language Pathologist)
Other
Licensure / Certification Expiration Date:
Years Of Work Experience:
Clinical Areas Willing To Work: Hospitals
Clinics
Physician's Offices
Long Term Care Facilities
Adult Correctional Facilities
Juvenile Correctional Facilities
Schools
Private Duty in the Hospital
Private Duty in the Home
Parts of Greater Houston Willing To Work: North
NE
NW
Central / Downtown
SE
SW
I Work The Following Specialties: Assisted Living
Burns
Cardiac Catheterization
Case Management
CCU (Coronary Intensive Care)
Chemotherapy
Clinic
Correctional
CVA / Stroke
CVICU (Cadiovascular ICU)
Diabetes
Dialysis, Hemo
Doctor's Office
ED (Emergency Dept.)
GI Lab / Special Proceedures
Geriatrics
Hand Specialization
Home Health
Hospice
Intermediate Care / Telemetry
Industrial / Occupational
Infection Control
Infectious Disease
Labor and Delivery
Management
Medical Surgical
MICU (Medical Intensive Care)
Mother / Baby
Neo ICU (Nursery Level III)
Neurological
Neuro ICU
Nursery Level I
Nursery Level II
OB / GYN
Oncology
OR Inpatient
OR Outpatient
Orthopedics
PACU (Post-Anesthesia Care)
Private Duty
Pediatrics
Pedi ICU
Post Partum
Psychiatry
Rehabilitation
School
SICU (Surgical Intensive Care)
Skilled / Long Term Care
Utilization Review
Other
Shift Preferences: Day Shift
Evening Shift
Night Shift
Any Shift
Are You Able To Rotate Weekends?:
Do You Speak Spanish?:
Do You Speak Any Other Foreign Languages?:
*Name:
*Address:
*City:
*State:    *Zip:
*Day Phone:
*Evening Phone:
Cellular:
Fax:
*Email:
Date and time that you would like to apply in the UltraStaff Office:
Please list any questions and/or comments below: