Strike - Lucid Medical Staffing

Strike Sign Up Form

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Name *

First

Last

Email *

Phone *

Do you have experience as an IR RN or an IR Tech? *

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? *

Total years of IR Rad Tech experience? *

Email Tech? in

Are you proficient in Pediatrics or Neuro? (select all that apply: PALS, Neuro, N/A) *

Are you proficient in Neuro or Vascular? (Select All that apply: Neuro, Vascular, N/A) *

Prior or Current KP Experience (Select One: Prior, Current, None) *

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

CA License Number *

Epic Experience Y/N? *

Are you able to be in SoCal for Start date between 12/26-1/10 *

Are you available to work 5 full weeks? *

RN License Number *

ARRT License Number *

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