Potential Multi-state Strike
Submit Request
Dental Assistant - Oregon
Requirements
:
BLS
Dental Assistant National Board certification
Oregon state Dental Assistant certification
Oregon state certificate of Dental Radiological Proficiency
First Name
*
Last Name
*
Email
*
Phone
*
Do you have BLS certification?
*
No
Yes
List any other certification you have:
*
Do you have the COVID Vaccination?
*
No - Requesting Exemption
Yes - Vaccinated
Yes - Vaccinated with Booster
Typically for strike assignments: 5x12/hr shifts (60/hrs week) Are you ok with this?
*
No
Yes
Can you work a Day shift?
*
No
Yes
Can you work a Mid shift?
*
No
Yes
Can you work a Night shift?
*
No
Yes
What is your Primary Shift preference?
*
Day
Mid
Night
100% Flexible
How many years experience do you have as a Dental Assistant?
*
None
6 Months or less
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
More than 10 Years
Have you worked as a Dental Assistant in the past year?
*
No
Yes
At what facility/organization have you worked as a Dental Assistant most recently?
*
What formal training have you had as a Dental Assistant?
*
Describe your experience as a Dental Assistant:
*
Please supply an Emergency Contact name and phone number:
*
