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 |
|
|
| Federal W-4 |
|
PDF |
| I-9 Packet |
|
PDF |
| Physician's Statement |
|
PDF |
| Required Documentation Checklist |
|
PDF |
| Payroll and Time Sheet Information |
|
PDF |
| Direct Deposit Application |
|
PDF |
| Reimbursement Form (Mileage, Licenses, Certifications) |
|
PDF |
| Evaluation |
|
PDF |
Skills Checklists
The skills checklists can now be completed via our nurse portal. To access the nurse portal click here. If you do not have a nurse portal user ID and password please contact your recruiter at 888-389-7668.
Workers
Compensation
Instructions
for Filing a Claim for Injuries on the Job
|
