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Part 1: Applicant Information
*
Indicates a required field
*
Name:
Address 1:
Address 2:
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
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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
Washington D.C.
West Virginia
Wisconsin
Wyoming
*
Zip:
*
Phone:
Best time to call:
(EST)
Cell Phone:
Best time to call:
(EST)
*
Email Address:
Part 2: Profession
Select your profession:
PT
OT
SLP
PTA
COTA
School Nurse
School Social Worker
School Psychologist
Special Education Teacher
Speciality:
(Check all that apply, hold Ctrl key for multiple selections - Mac users, hold Command key)
Please select...
Home Care
Hospital Inpatient
Hospital Outpatient
Rehab
School
SNF
Sports Med
Sub-Acute
Workers Comp
Other
Desired work setting:
(Check all that apply, hold Ctrl key for multiple selections - Mac users, hold Command key)
Please select...
Home Care
Hospital Inpatient
Hospital Outpatient
Industrial Rehab
Rehab
School
SNF
Sports med
Sub-Acute
Other
Job Type:
(Check all that apply)
Travel Assignment
Local Temporary
Direct Placement
Temporary to Hire
Education Staffing Services
Part 3: Additional Information
What States would like to work in?
(Check all that apply, hold Ctrl key for multiple selections - Mac users, hold Command key)
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
Washington D.C.
West Virginia
Wisconsin
Wyoming
What States are you currently licensed in?
(Check all that apply, hold Ctrl key for multiple selections - Mac users, hold Command key)
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
Washington D.C.
West Virginia
Wisconsin
Wyoming
What is the earliest date you
are available to work?
How did you hear about Prime
HealthCare Staffing?
Please Select
Mailer
Trade Show
Advance Magazine
Classified Ad
Professional Association
Other Advertising
Internet
Co Worker
Friend
Other
Part 4: Upload your resume
Please attach you resume in an MSWord ".doc" or any other word processors ".rtf" file type by clicking the "Browse" button below.
Attach Resume:
Quick Job Search
Profession:
Please select...
COTA
Occupational Therapist
Physical Therapist
PTA
Speech Language Pathologist
State:
(Any State)
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
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