RN HOME HEALTH Full Time ELMORE COMMUNITY HOSPITAL Posted 1 week ago Full Time ELMORE COMMUNITY HOSPITAL Posted 1 week ago Personal InformationName* First Last Email* Phone*Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Who could be contacted if you cannot be reached?Name* First Last Relation*Phone*Job InformationShifts* Day Night Evening Rotating Specify type of work desired* Full Time Part Time Temporary SUPP/PRN Willing to work holidays?*YesNoWilling to work weekends?*YesNoDate you can begin?* Date Format: MM slash DD slash YYYY Are you legally able to work for all employers in the United States?*YesNoEducationHighest education completed*12345678910111201020304Graduate hours*High SchoolHigh School Name*High School City*High School State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificHigh School Dates Attended*Ex: Aug 2011 - May 2015Did you graduate?*YesNoDiploma or Degree Received?*YesNoCollegeCollege 1: Name*College 1: City*College 1: State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCollege 1: Dates Attended*Ex: Aug 2011 - May 2015College 1: Did you graduate?*YesNoCollege 1: Diploma or Degree Received?*YesNoCollege 1: Courses or Major*Did you attend a second college?*YesNoCollege 2: Name*College 2: City*College 2: State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCollege 2: Dates Attended*Ex: Aug 2011 - May 2015College 2: Did you graduate?*YesNoCollege 2: Diploma or Degree Received?*YesNoCollege 2: Courses or Major*Did you attend a third college?*YesNoCollege 3: Name*College 3: City*College 3: State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCollege 3: Dates Attended*Ex: Aug 2011 - May 2015College 3: Did you graduate?*YesNoCollege 3: Diploma or Degree Received?*YesNoCollege 3: Courses or Major*Graduate SchoolDid you attend graduate school?*YesNoGrad School: Name*Grad School: City*Grad School: State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificGrad School: Dates Attended*Ex: Aug 2011 - May 2015Grad School: Did you graduate?*YesNoGrad School: Diploma or Degree Received?*YesNoGrad School: Courses or Major*Nursing SchoolDid you attend nursing school?*YesNoNursing School: Name*Nursing School: City*Nursing School: State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificNursing School: Dates Attended*Ex: Aug 2011 - May 2015Nursing School: Did you graduate?*YesNoNursing School: Diploma or Degree Received?*YesNoNursing School: Courses or Major*Other EducationAny other school or training?*YesNoOther: Name*Other: City*Other: State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificOther: Dates Attended*Ex: Aug 2011 - May 2015License Number, State, and Expiration DateList Certifications and/or Registrations & Expiration DatesCertification / Registration 1Expiration Date 1Certification / Registration 2Expiration Date 2Name of Professional or Trade Organizations to Which You BelongMiscellaneousHave you previously worked at Elmore Community or Lake Martin Community Hospital?*YesNoWhen?*If employed under a name different from above ( maiden name, nickname, ect. ) Please list*Names of friends and/or relatives employed at Elmore Community or Lake Martin Community HospitalName 1Relationship 1Name 2Relationship 2OtherHave you ever been convicted of a felony?*YesNoPlease explain:*U.S. MilitaryAre you a veteran?*YesNoDates of Service*Type of Duty*Service School or Special Training received (When and What?)*Employment: Starting With Present or Most Recent, List All Previous EmployersEmployer 1: Dates of Employment*Employer 1: Starting Salary*Employer 1: Current Salary*Employer 1: Company*Employer 1: Name (If Different)Employer 1: Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Employer 1: Job Title*Employer 1: Job Duties*Employer 1: Telephone Number*Employer 1: Supervisor’s Name*Employer 1: Supervisor’s Title*Employer 1: Reason for Leaving*Employer 1: May We Contact This Employer?*YesNoWhy?*Employer 2: Dates of Employment*Employer 2: Starting Salary*Employer 2: Current Salary*Employer 2: Company*Employer 2: Name (If Different)Employer 2: Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Employer 2: Job Title*Employer 2: Job Duties*Employer 2: Telephone Number*Employer 2: Supervisor’s Name*Employer 2: Supervisor’s Title*Employer 2: Reason for Leaving*Employer 2: May We Contact This Employer?*YesNoWhy?*Employer 3 Dates of EmploymentEmployer 3: Starting SalaryEmployer 3: Current SalaryEmployer 3: CompanyEmployer 3: Name (If Different)Employer 3: Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Employer 3: Job TitleEmployer 3: Job DutiesEmployer 3: Telephone NumberEmployer 3: Supervisor’s NameEmployer 3: Supervisor’s TitleEmployer 3: Reason for LeavingEmployer 3: May We Contact This Employer?YesNoWhy?*General SkillsPlease Check Areas in Which You Have Had Experience or TrainingOffice Equipment Multi-line Phone Copy Machine 10-key Calculator Fax Machine Filing Alphabetical Filing Numerical Data Entry Medical Transcription Medical Terminology ICD-9-CM Coding Hospital Housekeeping Institutional Food Service Inventory Control Professional Floor Care Typewriter WPM:*Computer SkillsComputer Software Word Excel dBase Windows Microsoft Office Other Software: Specify:*Operating systems Windows for Workgroups Microsoft NT DOS Unix Novell Other OS Networking Programming What programing languages?*Miscellaneous Others:Medical SkillsGeneral Clinical Skills Quality Management Staff Patient Student/Preceptor IV Therapy Venipuncture Adult Pediatric Newborn Patient Chart/Documentation Vital Signs Cardiac Monitoring EKG Nursing Skills Central Sterile Emergency Endoscopy/OP Surgery Intensive Care SICU/CCU Long-term Care Medical/Surgical OB/GYN/Neonatal/NICU Oncology Orthopedic/Neuro Pediatrics Psychiatric Recovery (PACU) Surgery Telemetry Laboratory Skills Blood Bank Chemistry Cytology Hematology Histology Microbiology GXT9 (Graded Exercise Test) STAT Lab Urinalysis/Coagulation Lab Equip./Instruments Laboratory Testing, Please list types of lab equipment, lab testing, specimen analysis.Radiology Skills CT Mammography MRI Specimen Analysis Nuclear Medicine Ultrasound Pharmacy Skills IV Admixtures/Piggybacks/Syringes/Chemo Patient Nutrition Support Patient Discharge Consults Automated Dispensing Equipment Medication Dispensing Oral/Liquid Medication Repacking Equip. Describe nutrition support, IV, or repacking experience:Please Read Carefully: Applicant Certification AgreementI authorize any employer, school, or person named by me to release any information regarding me or my employment. I hereby release said individuals or organizations from liability for any damage for issuing such information. I certify that the answers given by me to the foregoing questions and statements are true and correct. Further,. any falsification, omission, or misrepresentation of information supplied by me, either orally or on any company document, will be sufficient cause for elimination from continued employment. I understand that neither this document nor any offer of employment from the employer constitutes an employment contract. Furthermore, I understand that any employment is “at will”, which means that either I or Elmore Community Hospital or Lake Martin Community Hospital may terminate my employment at any time with or without cause, reason, or notice. No manager or representative of Elmore Community Hospital or Lake Martin Community Hospital has any authority to enter into an agreement of employment for any specified length of time. In making this application for employment, I agree to submit to a post-offer pre-employment drug and health screen. Should the results of this be unsatisfactory in the judgement of Elmore Community Hospital or Lake Martin Community Hospital, the job offer will be withdrawn. If offered employment, Elmore Community Hospital and/or Lake Martin Community Hospital will be required to verify my identity and eligibility to work in the United States of America, in accordance with the Immigration Reform and Control Act. I understand that documents to verify my identity and eligibility for employment may be submitted in accor dance with regulations of the US Immigration and Naturalization Service. Submitting this information is an acknowledgement that I have read and understand this document.Elmore Community Hospital and/or Lake Martin Community Hospital is an equal opportunity employer. Elmore Community Hospital and/or Lake Martin Community Hospital considers applicants for all positions without regard to race, color, religion, sex, national origin, marital or veteran status, the presence of disability, or any other legally protected status. Recent Jobs RN HOME HEALTH ELMORE COMMUNITY HOSPITAL Full Time HOME HEALTH LPN ELMORE COMMUNITY HOSPITAL PRN EMERGENCY ROOM REGISTRATION Anywhere Part Time HOUSEKEEPING PRN Anywhere Part Time
