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Corporate Office

1415 Troup Hwy.

Tyler, Texas 75701

Tel: (903) 526-8600

Fax: (903) 526-8601

 

Dallas Office

7502 Greenville Ave.
Suite 500
Dallas, Texas 75231Tel: (214) 630-5600

Fax: (214) 889-5000

 

Toll Free:

Tel: (866) 839-5627

Fax: (866) 526-8601

 

Download Enrollment Documents

In order to get the ball rolling, we need the following forms (download below) to be completed:

  • A Curriculum Vitae (application);

  • Clinical Skills Checklist;

  • Reference Release Form; and

  • A completed Hepatitis B Statement

We will also need:

  • A current (within one year) PPD or chest x-ray results;

  • Copies of all certifications (You must have a CPR; include all other certifications);

  • Copies of all licenses;

  • A completed W-9; and

  • Documentation certifying your eligibility to work as a contractor in the US, including a completed I-9 and copy(ies) of (a) state drivers license and social security card or (b) US passport.

If you would like to take advantage of direct deposit, contact us directly to set up that process.

We have provided these forms in PDF format for you to download and print.  Please complete and sign these initial documents, then mail or fax (toll free) them to us at (866) 526-8601.  If you do not have Adobe Arcobat Reader, we have provided a link below for the free download of a copy for your system.

 
 
Curriculum Vitae (RN/LVN)   Reference Release Form
Clinical Skills Checklist   Hepatitis B Statement
I-9 (2005)   W-9
W-4 (2005)      
 
Download a no-charge copy of the Adobe Acrobat Reader from the Adobe web site.

 

For any questions, call us toll free at (866) 839-5627or e-mail us!