JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Pain Leaders (Career Posting): Contact information
For Career Posting only
If you are interested in submitting a Job Posting, please use the form below.
* Indicates required question
Brief Description of Position (This will be included as a summary of position)
*
Your answer
Name (Main Contact Receiving Prospective Candidates)
*
Your answer
Email (Main Contact Receiving Prospective Candidates)
*
Your answer
Phone (Main Contact Receiving Prospective Candidates)
*
Your answer
Preferred start date of hire.
*
Your answer
PM&R, Anesthesiology, Multi-specialty Based?
*
Your answer
Employment status: W2 (employed) or 1099(contractor)?
*
W2
1099
Combination W2/1099
Required
Location (Please include actual city/town) [use of phrases like near metro, or convenient to downtown will not be allowed] (You may say the exact distance from major city if actual city and town are included.)
*
Your answer
Malpractice coverage?
*
Yes
No
Required
Medical Insurance paid?
*
Yes
No
Required
Disability Insurance paid?
*
Yes
No
Required
Retirement Plan paid?
*
Yes
No
Required
Salary Base
*
Your answer
Sign-on Bonus?
*
YES
No
Required
Relocation Reimbursement?
*
YES
No
Required
Paid Time Off (not including CME and Holidays)
*
Your answer
CME (Days and Reimbursement)
*
Your answer
Other Benefits (401K, 403B, Dividends, ASC Profit Sharing, %Collections, etc. )
*
Your answer
Is Call Expected? (If Yes, how many Days/Month)
*
Your answer
Weekends hours expected? (if yes, how many)
*
Your answer
Fellowship Requirement?
*
Pain Management (ACGME Accreditation), Candidate in ABA exam System (BE/BC)
Not Required
Other:
Required
Full Description
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms