RNPartner | Submit for placement
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Submit for placement

Recruiter Name:

First Name

Last Name

Agency Name

Mail check to address

City

State

zip

Phone

Fax

E-Mail Address

Candidate Information:

Candidate First Name

Middle Name

Last Name

Home Address (No PO Boxes)

City

State

Zip

Home Number

Cell Phone

E-Mail Address

Is a drug screen required?
YesNo

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.

Start Date

Estimated End date

Pay Rate

Per Diem:

Overtime Pay Rate:

Please include Job Description for workers compensation coverage.Please list all other relevant information concerning the candidate:

Client Company Information:

Client Facility Name

Facility Type

Website

Billing Address

City

State

Zip

Who will approve the canditate's timesheets?

First Name

Last Name

Title

E-Mail

Phone

Fax

Address at work location (no Po Boxes)

Street address

city

State

Zip

Send Contract to

First Name

Last Name

Title

E-Mail

Phone

Fax

Send Invoices to

First Name

Last Name

Title

Can we email invoices?

Phone

Fax

Recruiter Checklist

Please check the appropriate column to indicate whether or not the recruiter has completed the item.

INFORMATION PERTINENT TO THE RECRUITER(S)

YesNo Have you received approval from candidate for submission?

INFORMATION PERTINENT TO THE CANDIDATE

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?

INFORMATION PERTINENT TO THE CLIENT

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?


Questions : Call us now
1-800-590-1690

Note: The information provided on these forms is used to generate binding legal documents. Please confirm that all information shared is accurate.


IMPORTANT

Recruiters Email Address

For your record a copy of this data will be emailed to the address entered here.


Get in touch

OUR OFFICE

7000 N. Mopac Suite 200
Austin Texas 78731

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info@rnpartner.com

 

CALL US NOW

Phone   : 800-518-0698
Fax Line: 800-201-8653