American Mobile Healthcare - Travel Nurse Job Site for Nursing Professionals
Why American Mobile Healthcare
Nursing jobs
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For non-U.S. nurses
Thursday · July 29 · 2010
To speak with a recruiter about travel nursing positions, call (800) 282-0300 or email contact@americanmobile.com

The reference request form is the last step in our easy, 3-step application process. Simply submit the online form to your most recent employers. Your reference contacts will then complete the form and return it directly to American Mobile Healthcare. You will receive an e-mail confirmation after we receive each reference.

Remember, facilities we work with give preference to nurses with recent references on file, so be sure to complete the form as soon as possible so you don’t miss out on your next great opportunity!

Completing Your References:

Please complete this reference request by completing all required fields. A valid e-mail address for your reference contact is required. This form will be submitted to the contact's email address which you have provided. Please note that acceptable reference contacts include present or former supervisors, managers, team leads, charge personnel or other titles of individuals who currently supervise or previously supervised you in a work setting. Peer references are not applicable.

*Visit the Traveler Forms section if you need to download and print the Professional Reference Request Form.

Your Profile
Please enter your full legal name as it appears on your Social Security Card.
* First name: * Last name: Middle name:
Other First Name used: Other Last Name used:
* Email address:
* Last 4 of social security number:
- -
You can submit up to 3 reference requests. To add another reference request, click on "Add Another". To submit your reference request(s), please click "submit" at the bottom of the page.
Reference No. 1
* Evaluator First name: * Evaluator Last name:
* Evaluator Email address:
Facility Profile
* Facility name: * Facility type:
* Facility city: * Facility state: Zip code:
Unit Profile
* Unit/floor/dept name:
* Discipline: * Specialty:
* Number of beds in unit:
If not applicable, please enter n/a
* Average patient caseload:
1 : If not applicable, please select n/a
* Unit description:
May include common patient diagnoses, patient acuity, special equipment used, special skills/competencies, etc.
* Your position held:
Dates employed: (To date not required if currently working)
* From: To:
(mm/dd/yyyy) (mm/dd/yyyy)
* Charge experience?:
Attestation
 
I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. I hereby authorize the Evaluator to release employment information relative to this experience to AMN Healthcare. I understand this reference will be subject to verification by AMN Healthcare.
* *Date:
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