Forms

THANK YOU FOR VISITING MEDCARESTAFFING.COM FOR YOUR CONVENIENCE, WE HAVE INCLUDED DOWNLOADS AND FORMS YOU MAY NEED.

DOWNLOADS/FORMS:

FOR PROVIDERS (DOCTORS, NP/PA’S)

Provider Time Sheet – (Provider Time Sheet PDF) (Provider Time Sheet Word Doc)

W-9 pdf

Physician Application PDFPhysician Application (PDF) Physician Application (Word Doc)

PA/NP Application PDF

FOR HOSPITALS / CLINICS / URGENT CARE / MEDICAL FACILITIES

Request a doctor or NP/PA for temp (locums) or permanent positions

Provider Request Form

MedCare Staffing, Inc (MCS), is committed to providing risk management for both the physician seeking practice opportunities and the client recruiting physicians. We’ve instituted steps to make certain each placement is rewarding professionally, financially, personally and for your patients.

THE STEPS:

VERIFICATION

MCS does primary source verification of your education, training, privileges, board certification, and licenses.

APPLICATION

Providers must complete a MCS application that includes medical and legal questions and gathers essential information about your training and experience. This information will be revisited at least every two years during our reverification process.

References

Before you can work through MCS, we gather several verbal and two to four written professional references from medical professionals with whom you’ve worked closely.

DOCUMENTATION

You will need to provide copies of all required documents such as State License, DEA, Diploma, etc… see credentialing application.

EXPERIENCE

We will ask you to complete a medical scope of practice form to help us get a very good understanding of your skills and the scope of medicine within which you are comfortable and confident practicing. Self-awareness of your strengths and limitations is a very important part of success in locum tenens. Sharing that information with us is very important.

Queries of recognized monitoring sources

Individual state medical licensing boards

The Federation of State Medical Boards

The Office of Inspector General/Health and Human Services

Internal MCS approval

BUSINESS HOURS

READY TO SERVE YOU 24/7

Call our support hotline day or night (888) 474-3380)Contact MedCare Staffing - a locum tenens agency.