Refer a Nurse:

Refer a friend who is not currently in our database and if they complete an assignment with U.S. Nursing, we'll pay you a minimum of $500!* Please call for more details.

Please complete and submit the form below.

The fields in red are required.

* Referred nurse must meet assignment requirements

Please verify to make sure this information is correct before submitting. Please press the Submit button only once. Thank you.

Referral Name: *

Street Address:

City:

State: - None -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip:

Phone Number: *

Email:

Professional Level:

RN

ORT

CST

LPN/LVN

OTHER

Your Recruiter's Name:

Your Name: *

Word verification: * (verify using audio)

Type the characters you see in the picture above; if you can't read them, submit the form and a new image will be generated. Not case sensitive.