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RATES ON CONTRACT
Please enter rates as identified on the Clinician Contract which you endorsed.
Please select the patient population that you have prior experience with OR would be willing to learn by shadowing another clinician with experience in this area.
COVERAGE AREA & AVAILABILITY DETAILS
Please use the ZIP CODE SEARCH link (http://sterlingstaffingsolutions.com/PRS/zipcodesearch) provided in your Welcome Package to help locate your zip codes.
Once you find your zip codes, highlight the zip codes and click CNTRL-C on your key board to copy the text. Then click in the space to the left and select CNTRL-V on your keyboard to paste the text below.
Also, please check the Zip Code Check Listing PDF file that was attached to your Welcome Package email for extra help!!!
Enter as many 5-Digit Zip Codes separated by commas as you like.
Example: 77489,77459, 77071,77074
US CITIZENSHIP/ WORK AUTHORIZATION
Please complete the following questions truthfully.
APPLICATION VALIDITY STATEMENT
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Please inform SSS of any special circumstances or details HERE that may need to be considered.
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