Select Role *
Registered Nurse
Licensed Practical Nurse
Certified Nursing Assistant
Respiratory Therapist
Physical Therapist
Speech-Language Pathologist
Surgical Technologist
Radiology Technologist
Sterile Processing Technician
Occupational Therapist
Nurse Practitioner
Physician Assistant
Cardiovascular Technologist / Cath Lab Tech
Medical Laboratory Technologist
Licensed Clinical Social Worker
Other
Speciality *
Burn
Bone Marrow Transplant
Cardiac Cath Lab
Cardiovascular OR
Case Management
Coronary Care Unit
Dialysis
Endoscopy
ENT (Ear, Nose, Throat)
Emergency
Geriatrics
Gastrointestinal
Home Health
Intensive Care
Labor and Delivery
Long-Term Acute Care
Medical-Surgical
Mother-Baby/Postpartum
Neonatal Intensive Care
Neurology
Oncology/Hematology
Operating Room
Orthopedic
Outpatient Clinic
Outpatient Surgery/ Day Surgery
Post-Anesthesia Care Unit
Psychiatric/Behavioral Health
Rehab
Step Down/Progressive
Stroke
Telemetry
Trauma
Urology
N/A
Other
Do you work primarily with the Pediatric population?
No
Yes
How often did you float? (Per Assignment)*
0 Shifts
1-3 Shifts
4-5 Shifts
6+ Shifts
Average Patient Ratio *
1
2-3
4-5
6+
Overall Safe Practice: *
Radio
Radio
Radio
Radio
Radio
Traveler Friendliness: *
Radio
Radio
Radio
Radio
Radio
Overall Rating: *
Radio
Radio
Radio
Radio
Radio
Did the facility cancel your contract? *
No
Yes
Comments: *
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