Thank you for your interest in Surgical Exchange. In our commitment to providing superior service in Healthcare Personnel staffing,
we capture comprehensive information on your experience, skills, and background.
Please read each section carefully for instructions and specifications.
FULL APPLICATION
ADDITIONAL FORMS (PDF Only)
Please ask your physician to complete Page 1 of this form. You will complete Pages 2 and 3. Fax all three pages of the completed form to Surgical Exchange at the fax number at the top of the form.
REQUEST FOR REFERENCES
We require that you provide two (2) references.
MEDICAL-SURGICAL AND LONG-TERM CARE NURSE
(RN or LPN/LVN)
PERIOPERATIVE NURSE (PDF Only)
STERILE/CENTRAL PROCESSING TECHNICIAN
SURGICAL TECHNICIAN
In compliance with applicable laws, our company does not discriminate because of age, sex, race, color, religion, marital status, national origin, veteran status, or disability.
HIPPA Regulation: Healthcare and Health Plan Professional Compliance. As a representative of Surgical Exchange, you have the responsibility to protect all patients’ medical information so that it is not improperly used or disclosed, in accordance with federal and state law.
* The online application is hosted on a secure server, but if online security remains a concern for you, please use the printable PDF version of the application form.