This information will be shared with potential candidates for your position.

Please provide contact information (person who should receive candidate referral information) and the address for organization's main site:

Question Title

* 1. Please provide contact information (person who should receive candidate referral information) and the address for organization's main site:

If name/address of site where the clinician will practice is different from the main site information above, please provide the actual practice site details:

Question Title

* 2. If name/address of site where the clinician will practice is different from the main site information above, please provide the actual practice site details:

Start date -- when will the clinician need to begin work?

Question Title

* 3. Start date -- when will the clinician need to begin work?

Date 
What clinical discipline do you need [family practice physician, internal medicine physician, physician assistant, family nurse practitioner, etc.]? If the position may be filled by more than one discipline (either a family practice or an internal medicine physician, or a family physician or nurse practitioner or physician assistant), please indicate that.

Question Title

* 4. What clinical discipline do you need [family practice physician, internal medicine physician, physician assistant, family nurse practitioner, etc.]? If the position may be filled by more than one discipline (either a family practice or an internal medicine physician, or a family physician or nurse practitioner or physician assistant), please indicate that.

How many clinicians and what disciplines are at this practice location (# of physicians, # nurse practitioners, # physician assistants)?

Question Title

* 5. How many clinicians and what disciplines are at this practice location (# of physicians, # nurse practitioners, # physician assistants)?

Will you accept a J1 Visa candidate?

Question Title

* 6. Will you accept a J1 Visa candidate?

Indicate all answers that describe the site where the clinician will work:

Question Title

* 7. Indicate all answers that describe the site where the clinician will work:

Is the practice site in a health professional shortage area (HPSA), and if so what is the HPSA score and  type of designation?

Question Title

* 8. Is the practice site in a health professional shortage area (HPSA), and if so what is the HPSA score and  type of designation?

What are the best 3 things about being a practicing clinician at your practice site?

Question Title

* 9. What are the best 3 things about being a practicing clinician at your practice site?

Can the candidate expect a 40-hour week, and if not, what type of schedule will be expected?

Question Title

* 10. Can the candidate expect a 40-hour week, and if not, what type of schedule will be expected?

If your practice has multiple sites, will the person you hire only practice at one site or rotate among two or more sites? Please explain expectation.

Question Title

* 11. If your practice has multiple sites, will the person you hire only practice at one site or rotate among two or more sites? Please explain expectation.

If hospital coverage is required, please say more about what is expected. How is back-up call provided when the provider is away?

Question Title

* 12. If hospital coverage is required, please say more about what is expected. How is back-up call provided when the provider is away?

What is the salary range for this position?

Question Title

* 13. What is the salary range for this position?

What benefits are offered? CHECK ALL THAT APPLY.

Question Title

* 14. What benefits are offered? CHECK ALL THAT APPLY.

What things about the area/community would be the outstanding attractions [outdoors activities like hiking, biking, cultural opportunities, historical sites, etc.]?

Question Title

* 15. What things about the area/community would be the outstanding attractions [outdoors activities like hiking, biking, cultural opportunities, historical sites, etc.]?

Please send any marketing material and/or a photo of our site and/or community to dprimm@tha.com. Provide any additional job details that would attract a potential candidate to your job and the community.

Question Title

* 16. Please send any marketing material and/or a photo of our site and/or community to dprimm@tha.com. Provide any additional job details that would attract a potential candidate to your job and the community.

T