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Nurse Consultant Subcontractor Application

We are currently hiring nurse subcontractors. If you are interested in a nurse consultant subcontractor position, please complete the application below and submit

Name:
Date:
Title:
Address:
City, State & Zip:
Phone # :
(please indicate if cell or home/business)
Emergency Phone:
Contact Person:
E-Mail for project communication:
Current Position:
# Years as a RN:
Highest level of education:
Current Certifications:
Previous work as a legal nurse consultant:
No
What Type:
Duration:
Computer experience 
Yes No
Yes No
Yes No
Yes No
Other:
Rate Self:
I Use:
I have attended workshops/classes for legal nurse consulting:
Yes No
    When:  
    Where:  
 
Hours/wk available for project:
 
Best Time to Contact:
 
 
 
Please Answer the Following Questions:
 
Define the Standard of Care:
Define the Standard of Practice::
List the four elements of malpractice:
Who is the most important person of the case?
Why are manhole covers round (in 50 words or less)?
 
 
 

I understand submission of this information is a guarantee the information is true and accurate. 

I understand submission of this information is not a guarantee of hire.