Independent Health

Recruiting Request Form

Please complete the form below.

Hiring Manager(Required)

Address(Required)

Phone Number(Required)

Email(Required)

Additional ContactSection Break(Required)

Additional Contact Phone Number(Required)

Additional Contact Email(Required)

Number of Positions(Required)

Job Title(Required)

Duration(Required)

Contract Type(Required)

Job Description(Required)

Job Responsibilities(Required)

Pay Rate(Required)

Work Shift(Required)

Shift Differential(Required)

Other Recruiting Agencies?(Required)

Local or Out of State Travel?(Required)

Start Date/Time(Required)

Interview Availability(Required)

Drug Screen?(Required)

Background Check?(Required)

Other Checks(Required)

The completed form will be sent to independenthealthrecruiting@acarasolutions.com.