FLEXIBLE PHARMACY SERVICES CLIENT COVERAGE REQUEST FORM
Flexible Pharmacy Services, PLLC provides clinical pharmacy consulting and pharmacy staffing in a variety of settings. We offer highly-motivated pharmacists, pharmacy technicians, and other support staff primarily to pharmacies in need of temporary or permanent staff coverage. Let us know how we may help you and we will do our best to help you quickly!  You may call us at (323) 539-3032.
[IF YOU ARE A PHARMACIST OR A PHARMACY TECHNICIAN LOOKING FOR WORK PLEASE APPLY AT http://bit.ly/PRNss]
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Client Contact Name *
Best person for us to reply
Your name
 (if different from above)
Phone Number *
Best number for us to call or text back. You may also want to note best time to call or text
Email *
multiple emails are fine, if you all want to be cc'd.
Client Company Name *
The company that would be asking for services from our agency.
Client Company Website
If your company doesn't have a full-blown website, but has Facebook, Instagram,  or LinkedIn page, you may note them here.
Client Job site Location(s)
maybe substitute link to locations, or generally explain, if listing is cumbersome.
What pharmacist roles does your company need temps, contract, or permanent hire coverage for?
Job title not listed?  No problem. Just add to "Other".
What pharmacy technician roles does your company need temps, contract, or permanent hire coverage for?
Job title not listed?  No problem. Just add to "Other".
What nursing roles does your company need temps, contract, or permanent hire coverage for?
Job title not listed?  No problem. Just add to "Other".
What non-licensed supportive roles does your company need temps, contract, or permanent hire coverage for?
Job title not listed?  No problem. Just add to "Other".
How soon would you like this project to start? *
Feel free to list any key factors.
Is there a known project end date?
Feel free to list any key factors.
Additional project details.
 You might include special skills needed, or the anticipated work schedules, if known.  
Documents and Files Related to this need
Feel free to email any documentation or job descriptions, etc.to Jason@flexiblerx.com
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