Join Our Team- Application

Absolute Senior Help – Candidate Application

Apply to join our registry (RN, LVN/LPN, CNA, Phlebotomist). Fields marked with are required.

1) Applicant Info

First name

Last name

Date of birth

Mobile phone

City, State

2) Role & Credentials

Applying as

License type

License number

License expiration

BLS expiration

Other certs (ACLS, PALS, etc.)

3) Availability & Preferences

Earliest start date

Preferred weekly hours

Shifts

Desired pay (USD $/hr)

Max travel distance (miles)

4) Experience & Skills

Years of experience

Settings worked

Core skills (comma-separated)

Tip: include special populations (vent, trach, TPN, dementia, hospice) and devices (PICC, port, Foley, PureWick, feeding pumps).

5) Compliance & Documents

SSN last 4

Work authorization

Background check status

Immunizations / TB

Resume / docs link

Upload Resume ONLY. All licenses, certifications, medical documents, and compliance records must be emailed securely to: info@absolutemedstaffing.com This ensures protection of your personal information and maintains HIPAA compliance.(PDF, DOC, DOCX, JPG, PNG) – max 5 MB

Only the listed file types are allowed. Executables and archives are blocked.

6) Emergency Contact

Name

Relationship

Phone

7) Agreements

I agree I’m applying as an independent contractor and that all information provided is true.

I will comply with HIPAA and maintain confidentiality for all clients.

I consent to be contacted via email/text about shifts, onboarding, and compliance.

8) Anything else? Notes