Finding the Perfect Doctor Job

Okay, let�s get down to business in finding you that ideal doctor job you have in mind! We�ll begin by identifying what you�re looking for in a practice opportunity.

Please complete each section below and �submit� your Practice Search Parameters (a.k.a. my 'marching orders'!). Soon you�ll receive an email from me requesting your CV. (My email address is not posted on this site to keep the SPAMMERS unemployed.)

Doctor, rest assured that I will NOT share your CV with anyone until you�ve given me the �green light� to do so. This is a solemn promise.

With that said, let�s get onto what you are looking for in a new practice opportunity.

Practice Search Parameters

Please note that all fields followed by an asterisk must be filled in.

Title*
Title*

	M.D.
	D.O.

First Name*
First Name*

Last Name*
Last Name*

E-mail Address*
E-mail Address*

Street Address*
Street Address*

City*
City*

State/Prov*
State/Prov*

Zip/Postal Code

Home Phone

Business Phone

Fax

Mobile Phone

Your Practice Specialty*
Your Practice Specialty*

Board Status*
Board Status*

Type of Practice You Desire*
Type of Practice You Desire*

	Solo (Hospital Sponsored)
	Single Specialty Group
	Multi-Specialty Group
	Employed Position
	No Preference

Please list your geographical preferences in the box below*
Please list your geographical preferences in the box below*

State Licensures (Possess or Applying)*
State Licensures (Possess or Applying)*

When are You Available to Accept the Position (Month/Year)*
When are You Available to Accept the Position (Month/Year)*

Best Time & Method to Reach You*
Best Time & Method to Reach You*

Any special considerations that must be taken into account? (Family needs, practice specifics you require)

Citizenship Status*
Citizenship Status*

	US Citizen
	Permanent Resident
	H1B Visa
	J1 Visa

Have you had any restrictions or disciplinary action placed on your license at any time by either the DEA, State or Federal governments?

	Yes
	No

Have you had any Malpractice settlement judgments in the past 5 years?

	Yes
	No