Forms & Information
Skills Checklists
Workers’ Compensation
As a U.S. Nursing employee, you may
need to complete a variety of forms that are important for
your assignments. Remember, the more current your application
is, the more likely you will be selected for an assignment.
All forms below are in
Adobe Acrobat (pdf) format. If you do not currently have
Adobe Acrobat, please download
this application for free. Where indicated, you may fill
out some of these items online.
You may fax forms
to our Records Department at: (888) 508-7854.
Forms & Information
| COMPLETE U.S. Nursing
Application |
|
|
| Clinical Evaluation |
|
PDF |
| Direct
Deposit Application |
|
PDF |
| Education
Reimbursement Form |
|
PDF |
| Federal
W-4 - 2008 |
|
PDF |
| I-9 |
|
PDF |
| Payroll
and Time Sheet Information |
|
PDF |
| Physician's
Statement |
|
PDF |
| Primary
Applicant Agreement (PAA) |
|
PDF |
| Request for Reference |
|
PDF |
| Required
Documentation Checklist |
|
PDF |
| Employment Experience |
|
PDF |
| Travel
Reimbursement Form |
|
PDF |
Skills
Checklists

Workers
Compensation
Instructions
for Filing a Claim for Injuries on the Job

|