Begin your adventure with SSNGet to know you better Personal Information: * First Name Last Name Phone (###) ### #### Email * Professional Details: Specialty (Select up to three): PCU ICU Telemetry Other (Specify) Years of Nursing Experience Length of Time as a Travel Nurse States Licensed In Contract Preferences: Preferred Shift: Day Shift Night Shift Either Contract Duration: (Select all that apply): 8 Weeks 13 Weeks Unsure Previous Experience: Hospitals Previously Worked At (List any you would like to work with again) Requested Time Off (RTO) Start Date MM DD YYYY End Date MM DD YYYY Work Location Preferences: - Desired Cities - Desired States - Preferred Hospitals Technical Proficiency: Systems Familiar With (Select all that apply): Cerner Meditech Epic Allscripts AdvancedMD Other (Specify) Thank you!
