Pennsylvania - Potential Strike

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Occupational Therapist

Requirements:

BLS
Pennsylvania OT License

First Name*

Last Name*

Email*

Phone*

Do you have an active Pennsylvania OT license?*

No

Yes

PA OT license #?*

PA OT License Expiration Date:*

Do you have BLS certification? *

No

Yes

List any other certification you have:*

What specialties do you float to?*

Do you have the COVID Vaccination?*

No

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 OT experience do you have?*

Have you worked OT in the past year?*

No

Yes

What Facility and City, state have you worked OT most recently?*

What type of setting do you typically work in?*

What areas do you specialize in?*