ketchmedical.com | Nurse Practitioner and Physician Assistant Information

Name

First Name

Last Name

Email

Phone

Preferred Method of Contact

Email Phone Other

Availability

Desired Specialty (See Medical Specialty Page)

I Would Like to Receive Training in This Specialty

Experience in Target Specialty (All That Apply)

None Experience in this specialty from before I enrolled in my NP/PA degree program Experience in this specialty during my NP/PA degree program Degree and certification in this specialty (e.g. PMHNP) Experience in this specialty after receiving my NP/PA degree

Desired Location(s) of Position (City, County or Region)

Desired Pay Range (Annual Salary or Hourly Wage)

Desired Schedule/Hours (All That Apply)

Full Time Part Time Call OK Telephone Call OK Will Consider Call For Extra Money Days Nights Weekends

Geographic Flexibility (All That Apply)

I strongly value a short commute I would be willing to exceed my desired commute for extra pay I would be willing to move for the right position/salary

For What Salary/Hourly Rate Would You Be Willing to Commute 1 Hour?

For What Salary/Hourly Rate Would You Be Willing to Commute 2 Hours?

For What Salary/Hourly Rate Would You Be Willing to Relocate?

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