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New Hire Documents

Please upload the following documents.

Click on "Choose file" to upload.

COVID Card

Completed COVID Card.

Check Stub

Voided check or bank form showing your routing and account number.

Drivers License

State drivers license.

Physical Exam

Physical exam / statement of good health.

TB / 2 step ppd. Not more than one year old.

Picture

A picture of yourself for your id badge. Needs to be on a solid color background, no selfies, must look professional.

Flu Vaccine

Completed Flu Vaccine - Only for New Jersey candidates.

CPR Card

CPR BLS - Only for LPN candidates.

I understand these documents will be used as part of the new hire, onboarding process.

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

Draw your signature with your mouse, tablet or smartphone Clear

I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Timestamp

Audit

January 29, 2023 11:49 am EDT

New Hire Documents Uploaded by Assist Medical Staffing - staff@assistms.com IP 104.128.161.243

February 6, 2023 1:15 pm EDT

Document owner richard@assistms.com has handed over this document to staff@assistms.com 2023-02-06 13:15:04 - 104.128.161.231