Kudzu Medical Job Application

Apply online today with your local Kudzu Medical staffing agency

Thank you for taking the time to complete our online employment application. Please fill out the application below as completely as possible. After completing your application, allow 45 minutes for processing and call our office so we can be sure we have all of your correct information.

To use our quick apply feature, click here to submit your resume.

*All applicants are asked to call your local Kudzu Medical staffing agency weekly to provide their availability.

I am over 18 and legal to work in the US

First Name

Middle Name

Last Name

Nickname or Preferred Name

Street Address

City

State

Zip Code

Home Phone

Cell Phone

Emergency Contact

Email Address

Are you filling out an application in our office?

Are you available for temporary work?

Are you available for temporary contract work?

GENERAL INFO

Which Kudzu Medical location are you applying for?

What is your Lifting Capacity?

Willing to work in a non smoking environment?

Driver's License Number or State ID Number

Issuing State

Are You Willing To Take A Drug Test Today?

History Of Criminal Convictions?

Conviction Details

What position is your primary specialty?

What is your sub-specialty?

Position Applying For

Where did you hear about us?

AVAILABILITY

Shift Preference and Days Available

When are you available to start? (month)

Day

Year

Weekday Shifts

Weekend Shifts

What shift do you prefer?

How many hours are you willing to work in a week?

Are You Willing To Work Overtime?

What is the minimum pay you desire?

How many miles are you willing to travel

Please list the machines you are familiar with

Computer charting system you are familiar with

Please list any Medical Licenses or Certification

EDUCATION

Name of Institution

Street Address

City

Zip Code

Did you graduate?

Other Education

Name of Institution

Street Address

City

Zip Code

Did you graduate?

RECENT EMPLOYMENT (list most recent first)

Past Employer #1

Company Name

Street Address

City

State

Zip Code

Supervisor Name

Phone Number

Job Title

Start Date

Year

End Date

Year

Start Wage Hourly

End Wage Hourly

May We Contact This Employer For A Reference Check

Past Employer #2

Company Name

Street Address

City

State

Zip Code

Supervisor Name

Job Title

Reason for Leaving

Start Date

Year

End Date

Year

Start Wage Hourly

End Wage Hourly

May We Contact This Employer For A Reference Check

Past Employer #3

Company Name

Street Address

City

State

Zip Code

Supervisor Name

Job Title

Reason for Leaving

Start Date

Year

End Month

Year

Start Wage Hourly

End Wage Hourly

May We Contact This Employer For A Reference Check

SKILLS (check all that apply)

ICU: Intensive Care Unit

OR: Operating Room

CCU: Cardiac Care Unit

PACU: Post Anesthesia Care Unit

CVICU: Cardiovascular ICU

Geriatrics

NICU: Neurological ICU

Psychiatry

NICU: Neonatal ICU

Detox/Substance Abuse Care

PICU: Pediatric ICU

Medical Rehab

Respiratory

Telemetry

Oncology

Renal

Burn

Mom/Baby

Ob/GYN

ENT

Public Health

Pediatrics

Nursery

Orthopedics

Cosmetic/Reconstructive

Pre-Op.

Home Health

Hospice

Emergency Department

Pediatric Emergency Dept.

Flight Nurse: Helicopter/ Fixed Wing

Sane: Sexual Assualt Nurse Examiner

Trauma Center

Trauma - Major

Trauma - Minor

Trauma - Transport

Microsoft Excel

Microsoft Word

Microsoft Outlook

Quickbooks

Medical Coding and Billing

Medical Records

Data Entry

Insurance

Scheduling

Medical Receptionist

I certify that my answers are true and complete to the best of my knowledge. i understand that nothing in this application is a contract or offer of employment. I will be an at-will employee as it relates to 41-1-11-110 of the SC Code. Kudzu Staffing. Inc, or I may terminate employment at any time for any reason. No Kudzu Staffing, Inc. representatives can verbally or written by policy or practice change my at-will employment. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. Please take a moment to review your application. Indicate that you have read the above statement by entering your initials in the box below.

Kudzu Medical Job Application

Apply online today with your local Kudzu Medical staffing agency

GENERAL INFO

AVAILABILITY

Shift Preference and Days Available

EDUCATION

Other Education

RECENT EMPLOYMENT (list most recent first)

Past Employer #1

Past Employer #2

Past Employer #3

SKILLS (check all that apply)

Locations

Greenville, SC

Charleston, SC

Columbia, SC

Augusta, GA

Fort Mill, SC

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