Strike - Lucid Medical Staffing

Strike Sign Up Form

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Name *

First

Last

Email *

Phone *

to a exact

Total years of experience in IR? *

Do you have at least 1 year of recent (within the past 2 years) Interventional Radiology RN experience? *

Was that full-time, part-time, or PRN? *

Total years of RN experience? *

Do you have proficiency in Peds, Neuro/Vascular, General ?(select all that apply: PALS, Neuro) *

Do you have prior Strike Experience (Yes/No) *

CA License Number *

Epic Experience Y/N? *

Are you available for a 4 week Crisis after the Strike is completed? *

What's the soonest date you could fly out to CA (List exact date)? *

Date available until? (How long are you available to work?) *

RN License Number *

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