How To Become a Team Member

Applications

REQUIRED DOCUMENTATION CHECKLIST

(All copies must be clear)

The Documentation Below Must Be In Your File Prior To Placement.

Application Materials (forms provided in this document)

1. Job Application must be completed in full, including the Primary Applicant Agreement/Nurse Associate Professional Conduct Expectations. You may include your resume, but it will not replace a complete job application.
2. Completion of an I-9 form.
3. Two references or a performance evaluation with one other reference.

Clinical Skills Checklist(s) Please be sure you fill out all of the skills checklists that apply to you:

• Critical Care Nursing: Adult
• Critical & Intermediate Care Nursing: Pediatric
• Medical Surgical Nursing: Adult
• Intermediate Care Nursing: Adult
• Medical Surgical Nursing: Pediatric
• OR Technician
• Prenatal Nursing: Maternal (including Normal Newborn Care)
• Perinatal Nursing: Neonatal
• Perioperative Nursing
• Psychiatric Nursing: Adult and Pediatric

Medical Documentation

• A current physical or physicians statement within previous 12 months.
• Hepatitis B documentation (vaccination series of three, titer, booster, or signed declination).
• A TB screen current within 12 months or chest X-ray current within two years.
• Proof of immunity to Rubeola, Rubella and Mumps Proof of immunity to Varicella (Chicken Pox)-(positive titer or Varivax inoculation).
• Tetanus within 10 years, or signed declination.

Licenses, Professional Certifications, and Resuscitation Credentials

• Clear copies of all current nursing licenses and professional certifications.
• Clear copy of a current CPR card. If you have additional resuscitation credentials (ACLS, ENPC, NRP, PALS, TNCC), please send copies.
• Proof of eligibility to work within the United States (For example: a Social Security Card and a Driver's License, or Passport).

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