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| CRNA's Name (Preferred Name in parenthesis if desired) | Anonymous | |
| Contact Name | Anonymous | |
| Contact Email | Anonymous | |
| Contact Street Address 1 | Anonymous | |
| Contact City | Anonymous | |
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| Contact Voice Phone | Anonymous | |
| Preferred Contact Method |
| Brief Description of Candidate |
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| States where clinician wants to work |
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| Check any Position Durations you would consider: |
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| Date Available |
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| If Locum Tenens, to what end date can CRNA work? |
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| Does CRNA want a Chief CRNA position? |
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| Does CRNA want a job that leads to partnership? |
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| How often the CRNA wants to do the following: |
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| Does the CRNA want to be Medically Directed by an Anesthesiologist? |
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| What is the CRNA's preference regarding CRNAs in a job situation doing Operative Cases that are not Medically Directed by an Anesthesiologist? |
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| Does the CRNA want a job where there is an Approved Physician Anesthesia residency program? |
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| Does the CRNA want a job where there is Anesthesia training for Physician house staff? |
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| Does the CRNA want a job where there is a CRNA training program? |
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| Does the CRNA want a job where there is an Anesthesiologist's Assistant training program? |
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| What practice setting(s) does the CRNA have experience? |
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| Estimated Minimum Annual Income Desired (W-2 Salary or 1099 Payment) |
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| Employment Status Desired: Employee (IRS form W-2) or Independent Contractor (IRS form 1099). |
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If Locum Tenens, what is the CRNA's minimum daily charge? |
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| Does the CRNA want a Salary income from anesthesia group? |
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| Does the CRNA want a Percentage income from anesthesia group? |
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| Does the CRNA want an Income from Fee-for-service individual practice? |
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| Does the CRNA want a Salary from Hospital as an employee? |
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| Does the CRNA want Other income as a Hospital employee? |
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| How often Does the CRNA want to be on call? |
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| Does the CRNA want to have the Day off after call? |
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| States where CRNA is licensed |
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| CRNA's Degree |
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| CRNA's Nurse School | Anonymous | ||||||
| CRNA's Anesthesia School | Anonymous | ||||||
| Is CRNA Certified by the NBCRNA? NBCRNA = National Board on Certification and Recertification of Nurse Anesthetists |
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| Year of Primary Certification |
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| Comments about CRNA's NBCRNA Certification NBCRNA = National Board on Certification and Recertification of Nurse Anesthetists |
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| Has CRNA completed Subspecialty Extra training |
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| Does CRNA have Subspecialty Expertise but has not completed extra training? |
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| If CRNA has Subspecialty expertise or has completed extra training, which one(s)? |
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| Check which Life Support cards you currently have: |
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| Is CRNA a New Graduate? |
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| Current Employer Name | Anonymous |
| Current Employer Address/City/State/Zip | Anonymous |
| CRNA's reason for seeking a job change? | Anonymous |
| CRNA's Interests |
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| Name of a reference person | Anonymous | |
| Reference's email | Anonymous | |
| Reference's phone | Anonymous | |
| Comment or paste the text of your CV here, if desired. |
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| Date Posted | 07/17/22 04:52pm |
| Last Updated | 08/17/22 05:33pm |
| Reference # | 66060 |
| Priority | General Posting |
| Section | CRNA |
| Form Type | CV |
| User Type | Individual: CRNA |
