Application Information

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.

STEP #1: APPLICATION FORMS

All of the forms in this section MUST be received by Surgical Exchange before we can process your application. Please use the online version when available to avoid delays. If an online version is not listed for a form, please print the PDF version and fax the completed application to Surgical Exchange (our fax number is printed at the top of each form).

FULL APPLICATION

 

ADDITIONAL FORMS (PDF Only)

PHYSICAL EXAMINATION (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.

STEP #2: SKILLS and EXPERIENCE

You must complete a checklist for each position for which you are qualified and would like to be considered. Where available, please use the online form version of the checklist to avoid processing delays. The Job Summaries provide detailed descriptions of the requirements for positions.

CERTIFIED NURSE AIDE

 
MEDICAL-SURGICAL AND LONG-TERM CARE NURSE
(RN or LPN/LVN)

 
PERIOPERATIVE NURSE (PDF Only)

PSYCHIATRIC NURSE (PDF Only)

 
STERILE/CENTRAL PROCESSING TECHNICIAN

 
SURGICAL TECHNICIAN

STEP #3: FEDERAL PAYROLL FORMS

Below are links to the IRS and USCIS sites where you can complete a W-4 and/or I-9 form, as applicable. Selecting these links will open a new window. Be sure to return to the Surgical Exchange website to complete the application process.

 

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.