| *Name |
|
| *Street
Address: |
|
| *City, ST
Zip: |
,
|
|
*Phone: |
Cell Phone:
|
|
*E-Mail: |
|
|
(* Denotes a required entry.) |
| |
|
Do You
Have A Current Resume?
Yes
No
If yes, please attach it to this e-mail. |
Resume:
Expectable attachment types are MS Word ending with ".doc", PDF ending with ".pdf",
Text ending with ".txt", and ZIP Archive ending with ".zip". |
| |
| |
|
Position Desired:
Specialty:
Other:
|
Your Experience |
| |
|
Are You A Registered CMT?
Yes
No
|
| |
|
Where Did You Receive Your Training?
|
| |
|
How long have you been a medical
transcriptionist?
|
| |
|
What are your specialty
areas and how much experience do you have in each? |
1:
Experience:
|
2:
Experience:
|
3:
Experience:
|
4:
Experience:
|
| |
Do you own your own equipment?
Yes
No
If yes, what kind?
|
What
is your productivity and how is it measured?
|
How many hours are you available to
work per day?
|
What kind of transcription would you
most like to do?
|
Please provide
three references (all information is strictly
confidential)
|
|
1st Reference |
|
Name: |
|
| City/State/Zip: |
,
|
| Phone: |
Fax:
E-Mail:
|
| Work Type:
|
|
|
Comments: |
|
|
2nd Reference |
|
|
Name:
|
|
| City/State/Zip: |
,
|
| Phone: |
Fax:
E-Mail:
|
| Work Type: |
|
|
Comments: |
|
|
3rd
Reference
|
|
|
Name:
|
|
| City/State/Zip: |
,
|
| Phone: |
Fax:
E-Mail:
|
| Work Type: |
|
|
Comments: |
|
|
Is there anything else you would like us to know
about you?
|
|
|
|
| |
|
|
