For more than a decade, Roberta Chambers has been championing the rights of individuals like you in the areas of

Staffing Information Request
Use this quick online form to tell us about your staffing needs. Upon receipt, one of our representatives will review your requirements and contact you shortly.
Name:
   
Position/Title:
   
Name of Institution:
   
Address:  
   
City:
   
State:  
     
Zip:  
     
Country:
   
Country Code:
   
Office Phone: ext.
 


Cell Phone:  
   
Alternate Phone:  
   
Fax:  
   
Email Address:
   
Website:
   
Are you the primary contact for this institution? Yes
No
   
If no, please state the name of the primary recruiting personnel:  
   
Please state what type of nurse/specialization you are interested in:
(Check all that apply)		   Critical Care Nurse
ER  
ICCU  
Medical Surgical  
Neonatal  
Nurse Midwife  
Nurse Practitioner  
OB-GYN  
Orthopedic  
Pediatric  
PICU  
Recovery  
Registered Nurse  
Other (Please specify):  
   
Other Qualifications: (Check all that apply) BA Degree

    Certification in Specialty  
  MA Degree  
  PHD  
  Bilingual - English &  
  Chinese  
  Creole  
  French  
  Russian  
  Spanish  
       
Employment Types:   Direct Hires  
    Contract Position  
    Temp/Per Diem  
       
Comments:  
Form Validation: 8+2=  
 

 
 
 
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