Michigan Submit Request

First Name*

Last Name*

Email*

Phone*

Do you have BLS certification? *

No

Yes

Do you have ARRT certification?*

No

Yes

If yes, what is your ARRT number?

Do you have Fluoroscopy Certification?*

No

Yes

If yes, what is your Fluoroscopy certification number?

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 Rad Tech experience do you have?*

Have you worked as a Rad Tech in the past year?*

No

Yes

What Facility have you worked as a Rad Tech most recently?*

How much experience do you have in a hospital setting?*

How much experience do you have in an Outpatient setting?*

Have you worked in any other settings vs hopsital/outpatient? *

No

Yes

If so, how long and what type of settings?*

Can you work in any other modalities?*

No

Yes

Which brand equipment do you have experience with?*

Can you run a C-arm in the OR?

No

Yes

Have you worked in Trauma?*

No

Yes

Can you run fluoroscopy? *

No

Yes

If yes, what department have you worked Fluoroscopy in?

List any equipment you have experience with not listed above:

Michigan - Potential Strike

Submit Request