Medical Staff  

Visiting Temporary or Locum Tenens Application

*The application is available in PDF Format. You must have Adobe Reader in order to fill out this application.  If you do not have Adobe Reader you can download a free copy at http://adobe.com/downloads .

*To save this application, click on File and Save As. Save it somewhere you can easily find again, such as, your desktop.


Instructions:

  1. Open the PDF file: Visiting Temporary or Locum Tenens Application (PDF)
  2. Fill in the fields as appropriate
  3. Print the PDF
  4. Sign all areas requiring your signature

 

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