Neurology Physician

Department: Clinics- Hospital Status: Status: Full Time

Shift: N/AResume Resume: Supported formats: Word, PDF, RTF, Text, and HTML.- or Upload from: Contact Information* First Name:* Last Name:* Address 1:Address 2:* City:* State:* Phone:* Email: Opt-In Confirmation By submitting this application, I consent to receive SMS updates from Nevada Regional Medical Center at 8886919485 regarding my employment application. My information will not be shared or used for any other purposes. This application is powered by Applicant Stack on behalf of Nevada Regional Medical Center. SMS messages will only be sent by Nevada Regional Medical Center and are used exclusively for hiring-related communications when you have subscribed to receive SMS communications. Attachments You can type in a Cover Letter or Copy/Paste from an existing document. NRMC Health - Custom Application for EmploymentPERSONAL INFORMATION* Are you legally eligible to be employed in the United States? (Proof of identity and eligibility will be required upon employment) Yes No* Will you now or in the future require employer sponsorship to work in the United States? Yes No* Are you at least 18 years or older? (If no, you may be required to provide authorization to work) Yes No* Have you ever worked for this Company before? Yes NoIf Yes, please provide details (Where/When/Job Title)How did you hear about us?* Were you referred by a current employee? Yes NoIf yes, please provide name.* Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation? Yes NoIf no, please explain* Have you ever worked for Nevada Regional Medical Center, Moore Few Care Center or Barone Alzheimer’s Care Center? Yes No* Are you related to any current employees? Yes NoIf yes, please explain.* Have you ever been convicted of a crime? Yes NoIf yes, please explain. EMPLOYMENT DESIREDWhen would you be available to begin work? Type of employment desired Full Time Part Time Seasonal Hourly rate/salary desired Are you currently employed? Yes NoIf so may we inquire of your present employer? Yes NoIf presently employed, why are you considering leaving? EDUCATIONGive record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended. School 1 Name Location Did you Graduate? Yes NoDegree Received Subjects Studied/Major School 2 Name Location Did you Graduate? Yes NoDegree Received Subjects Studied/Major School 3 Name Location Did you Graduate? Yes NoDegree Received Subjects Studied/Major School 4 Name Location Did you Graduate? Yes NoDegree Received Subjects Studied/Major School 5 Name Location Did you Graduate? Yes NoDegree Received Subjects Studied/MajorSKILLSLicense or Certification Number State issued License or Certification Number State issued License or Certification Number State issued Do you have a Current/Valid Driver’s License Yes NoDo you have Proof of insurance Yes NoEMPLOYMENT HISTORYGive your full employment record, starting with your current or most recent employment. Employer 1 Job Title *From *To *Company Name *Company Address *Company Phone ***May we Contact? * Yes NoResponsibilities *Reason for Leaving *Employer 2 Job Title From ToCompany Name Company Address Company Phone May we Contact? Yes NoResponsibilities Reason for Leaving Employer 3 Job Title From ToCompany Name Company Address Company Phone May we Contact? Yes NoResponsibilities Reason for Leaving Employer 4 Job Title From