Mail check to address
Candidate First Name
Home Address (No PO Boxes)
Is a drug screen required?
NOTE: Staffing Branch conducts a drug screen and criminal background check on every healthcare worker we employ. The cost will be split between Staffing Branch (30%) and the recruiter (70%). The recruiter's share will be deducted from his or her first recruiter check from Staffing Branch.
Estimated End date
Overtime Pay Rate:
Please include Job Description for workers compensation coverage.Please list all other relevant information concerning the candidate:
Client Facility Name
Who will approve the canditate's timesheets?
Address at work location (no Po Boxes)
Can we email invoices?
Please check the appropriate column to indicate whether or not the recruiter has completed the item.
YesNo Have you received approval from candidate for submission?
YesNo Have you submitted the candidates resume, skills checklist and references to Cure?
YesNo Did you remind the Candidate that Cure must receive all completed employment materials (contract, W-4, Direct Deposit Info etc.) prior to their first payroll processing or their first check could be delayed?
YesNo Did you remind the Candidate that the he or she MUST undergo a background check?
YesNo Did you remind the Candidate that each week's time sheet must be received by 1:00 P.M. CST Monday, or the processing of the paycheck will be delayed?
YesNo Did you remind the Candidate that payroll is direct deposit every Friday?
YesNo Did you confirm the pay rate for the assignment with the candidate?
YesNo Did you submit questionnaire for the assignment?
YesNo Did you submit a pay rate breakdown?
YesNo Did you remind the Client Company that all invoices are "Due Net 30"?
YesNo Did you verify the duration of the contract with candidate (Start and End Dates)?
YesNo Did you remind the candidate that an authorized person MUST sign the candidates's time sheet so it can be FAXED by 1:00 p.m. EST on Monday or processing of the candidates's paycheck will be delayed?
Note: The information provided on these forms is used to generate binding legal documents. Please confirm that all information shared is accurate.
Recruiters Email Address
For your record a copy of this data will be emailed to the address entered here.
7000 N. Mopac Suite 200
Austin Texas 78731
Phone : 800-518-0698
Fax Line: 800-201-8653