Submit Your Staffing Needs |

As the industry's most comprehensive staffing solutions provider, our goal at AMN Healthcare is to partner with you to fill all your temporary, contract and permanent clinical healthcare positions—including providing you with highly qualified and experienced nurses, physicians and other allied health providers.

To make sure we meet all your clinical healthcare staffing needs as quickly and efficiently as possible, please complete and submit the following form. Your personal Hospital Account Manager will contact you within 24 hours (Monday–Friday). If you have any questions, please contact our Client Services department at (866) 871-8519.

Personal information:
* Indicates required field
* Facility name:
* Contact name:
Corporate affiliation:
Address:
City:
State:		Please select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip:
* Phone:
* E-mail address:
Fax:
Have you worked with AMN Healthcare before?:		YesNo
Positions / Specialties needed:
Number of positions needed:
Shift:		8 hr10 hr12 hr DaysEveningsNights
From date:		(mm/dd/yyyy)
To date:		(mm/dd/yyyy)
Reason for need:		Please select CME leave Emergency coverage Permanent search Practice expansion Seasonal coverage Staff replacement Transition coverage Vacation coverage Other
Brief position description / Comments:
By submitting this form, you consent to AMN Healthcare and its affiliates contacting you using the contact information provided.