Health Professional Vacancy Update Form

Please indicate any special requirements or preferences for your health professional ideal applicant (e.g. language skills, special experience, etc.).

Date completed:

Name of Facility:
Administrator/Executive Director:
Director of Nursing:
Personnel Director:
Other Contact:
E-mail Address:

By entering your name in the boxes below, you authorize New Mexico Health Resources, Inc., to use the information provided on this form at its discretion to assist in filling any vacancies indicated.
Authorized By: Date:
No current vacancies
PHYSICIAN NEEDS:

Specialty Training: Accept J-1?
FTE Date
Needed Locum Tenens Locum Tenens
Dates To Fill
ER to
Family Practice to
Internal Medicine to
OB/Gyn to
Pediatrics to
Psychiatry to
Dentist to
Other Physician:
to


PHYSICIAN ASSISTANT NEEDS:

Specialty Training:
FTE Date
Needed Locum
Tenens Locum Tenens
Dates To Fill
ER to
Family Practice to
Internal Medicine to
OB/Gyn to
Pediatrics to
Psychiatry to
Other Physician Assistant:
to


NURSE PRACTITIONER NEEDS:

Specialty Training:
FTE Date
Needed Locum
Tenens Locum Tenens
Dates To Fill
ER to
Family Practice to
Internal Medicine to
OB/Gyn to
Pediatrics to
Psychiatry to
Other Nurse Practitioner:
to

REGISTERED NURSE NEEDS:
(New Mexico State Personnel Classification, if applicable)

Specialty:
Day Evening Night Varies
Background Training/Experience Desired:
Willing to consider new graduates
Specialty:
Day Evening Night Varies
Background Training/Experience Desired:
Willing to consider new graduates
Specialty:
Day Evening Night Varies
Background Training/Experience Desired:
Willing to consider new graduates
Specialty:
Day Evening Night Varies
Background Training/Experience Desired:
Willing to consider new graduates

LICENSED PRACTICAL NURSE NEEDS:
(New Mexico State Personnel Classification, if applicable)

Specialty:
Day Evening Night Varies
Background Training/Experience Desired:
Specialty:
Day Evening Night Varies
Background Training/Experience Desired:

OTHER NURSING NEEDS:
(please list; NMHR will follow up for additional information)
THERAPIST NEEDS:

Specialty/Experience Desired
PTs
OTs
SLPs Dental
Hygenist

SPECIFY ANY OTHER HEALTH PROFESSIONAL NEEDS:

COMMENTS/DETAILS:
Please detail any particulars about your health professional recruitment needs.

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