CYS Short Notice

CYS Short Notice Assignments

 
This survey includes a listing of our current CYS Short Notice assignments. Please indicate your availability for the specific assignment dates listed!

1. Please enter the following demographic information:
2. What is your Provider Identification Number(PIN)? You must enter a correct PIN. If you do not know your PIN, please contact Professional Relations at 800-541-3353 BEFORE you submit this survey. Or, you can look up your number using the PIN Look Up tool at https://www.mhn.com/provider/pinLookup.do
Please check boxes below to indicate the assignment dates you are available for and interested in filling.
(note that dates listed are assignment dates and do not include travel dates.) Please CAREFULLY CONSIDER the dates listed, and ONLY check those for which you are certain you are available. This is only a useful tool if it's accurate, so we do ask that you are accurate in your responses.

3. I am available to fill the following rotation(s):
QUESTIONS REGARDING REQUIREMENTS:
4. I would characterize my presentation skills and experience as:
5. I have completed the following number of CYS/DoDEA rotations:
6. I have completed the following number of MFLC (non-CYS) rotations:
7. I have filled the following number of solo assignments:
8. MFLC-Europe experience: I have completed the following number of OCONUS/Europe assignments:
9. Have you completed a CYS Mentoring assignment? (if you do not know what this is, please answer "NO")
10. Are you a Base Opener?
11. Do you live near any military installations?
12. I attest that all information I have entered on this survey is true and correct.
13. I am tentatively scheduled for another MFLC assignment which may conflict with my selection(s) (above):
14. Add any additional notes here: (please restrict notes to specific additional information about this survey/these assignments. General questions and comments must be directed to mflc.program@healthnet.com. PLEASE DO NOT ENTER DATES OF AVAILABILITY. If you are not available for any of the dates listed above DO NOT SUBMIT THIS SURVEY. Dates entered in the Comments field will not be considered. However, if you would like to communicate your availability for assignment dates other than those listed here, we encourage you to do that by filling out our program Availability Survey, which you may access by copying this web address and pasting it into the Address window of your browser:
https://www.surveymonkey.com/s.aspx?sm=0zUn07Lu1SV7w2X4QXP_2biA_3d_3d )
Thank you for responding quickly to let us know that you are interested in/available for these short notice assignments! You'll be contacted if your experience/availability/location are a match for these assignments.
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