STAFFING POSITION REQUEST FORM (Interim Staff & Recruiting / Permanent Placement)

Please use your TAB key to move between fields.
Please complete all applicable fields in this form!
Name: *
Title: *
Hospital: *

Adress: *

City: *
State: *
zip: *
Phone: *
Email: *
 
INTERIM STAFF REQUEST
Interim Staff Needed:
Director of Pharmacy / Pharmacist-In-Charge
Clinical Pharmacist
Staff Pharmacist
Pharmacy Technician
   
Reason for Interim Staff:
Temporary While Recruiting
Difficulty Locating Staff for Open Position
Coverage
  
Anticipated Length of Assignment:
Short-Term
Long-Term
On-going
   
Anticipated Schedule:
Full-Time: Monday - Friday Days
Full-Time: Monday - Friday Evenings
7 on 7 off
Weekends
PRN
 
PERMANENT PLACEMENT / RECRUITING
Recruiting Assistance For:
Director of Pharmacy
Clinical Pharmacist
Staff Pharmacist
Pharmacy Technician
  
Hospital Demographics:
Type of Hospital:
Acute
Long Term Acute
Rehabilitation
Psychiatric
Surgical
Number of Beds:
Average Daily Census:
Pharmacy Hours:
Pharmacy Computer System Name:
Automation:
 Yes No
 
How Did You Hear About Us:
Direct Mail
Print Advertising
Website / E-Commerce
Referral from Hospital Doing Business with PharmaCare Services
Other
Contact:
 Aranya De Sola, SPHR, SHRM-SCP, Employment Manager
Recruiter
210-745-4002 x4003
aadesola@pharmacareservices.com