Find top talent with Merkins Staffing and Placement Agency, ensuring the perfect fit for your team's needs.

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Providers

Join Our Team

Apply now for RN, CNA/HCA, and LPN positions with our easy job application form.

Job Application Form for Healthcare Roles

Fill out our application for RN, CNA/HCA, and LPN positions.

Your First & Last Name*

Your email*

Position Applied For*

Registered Nurse (RN

Licensed Practical Nurse (LPN)

Certified Nursing Assistant (CNA)/HCA

Availability*

Full-Time

Part-Time

Weekends Only

Overnight Shifts

Travel Assignments

Crisis Staffing / Emergency Response

Licensure & Certifications

CPR Certified

BLS Certified

ACLS Certified

State(s) Licensed In, License Number, License Expiration Date*

Work Eligibility*

I am legally authorized to work in the U.S.

I have a valid driver’s license

I am willing to undergo a background check

Other

Skills Checklist*

Long-Term Care

Acute Care

Behavioral Health

Hospice / Palliative Care

IV Therapy

Medication Administration

Wound Care

Tracheostomy Care

Dementia / Alzheimer’s

Electronic Medical Records (EMR)

Signature & Consent*

I certify that the information provided is true and complete to the best of my knowledge.

I authorize Merkin Staffing to verify all information and contact employers and references

Signature*

Describe the following shortly; Education & Training, Work Experience, Preferred Work Locations (Cities/States), Minimum Hourly Rate Expected, Preferred Start Date, Additional Notes or Preferences.*

Care

Dedicated staffing for your medical facility needs.

Support

Trust

info@merkinplacement.com

+1206-304-0934

+1206-966-2623

Your email for contact

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