Healthcare Facility Sign Up

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*First Name
 
*Last Name
 
*Email Address
   
*Primary Phone
 
Phone Extension
 
Fax
 
*State
 
*Company Name
 
*Organization Type
 
*Title Needed
 
*Specialty Needed
Help for Specialty Needed Please select the primary specialty for which you are looking. You will not be restricted to this specialty in posting jobs.
 
*Assignment Type
Help for Locum Tenens or Permanent Job Duration Please select from the dropdown whether you're primarily recruiting locum tenens positions or permanent placements. You can also select "either" for both.
 
*Where did you hear about us?
 
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*Choose a Username
Help for Usernames Username should be between six (6) and twelve (12) characters. Usernames should only contain letters and numbers and are not case sensitive.
   
*Choose a Password
Help for Passwords Password must contain at least six (6) characters that include at least 1 numerical digit. Your password is case sensitive.
 
*Confirm Password
   
*Are you interested in Full-Service Agency Assistance?

Help for Agency Services MentalHealthWork.com offers full-service agency services to help you find the right candidate, right now! Leave this selection "Yes" so you can get our help. Or, if you'd prefer to do it on your own, select "No." Either way, you always post jobs for free!
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Help for Email Notification We will send email notifications to the email account used at registration to communicate site features, job opportunities/candidates, career-related content, etc.
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