Recruiter Referral Form

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I'll connect you with my favorite travel nurse recruiter! She's responsive and very helpful.

Note: I'm not going to sell your information or anything like that, I'm using this form to filter out fake leads. I don't want to publish her real contact information on the internet. Also, I want to make sure I get my referral bonus (duh!).

Email *

Name (First and Last) *

Phone Number *

Are you new to travel nursing? *

Yes

License *

RN - Registered Nurse

LVN/LPN - Licensed Vocational/Practical Nurse

RT - Respiratory Therapist

Other:

Specialty *

ER - Emergency Department

ICU - Intensive Care Unit

L&D - Labor and Delivery

MS - Medical/Surgical

Ortho - Orthopedics

PACU

PCU/Stepdown - Progressive Care Unit

Psych - Behavioral Health

Tele - Telemetry

Surgery

Other:

How many years of experience do you have in this field? *

What are you looking for in a travel nursing contract? Where do you want to go? What do you want us to know? Tell us anything! *

Send me a copy of my responses.

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