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Surgical Assistant

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Contact Information

First name

Last name

Birthday

Are you over 18 ?

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Background Check

Have You Ever Been Convicted of Any Crimes in the Past Ten Years, Excluding Misdemeanors and Summary Offenses, Which have Not Been Annulled, Expunged or Sealed by a Court?

If Yes, State the Offense, Location, Date and Disposition.(NOTE: A Conviction Will Not Necessarily Disqualify You From Employment.)

Phone

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Are You Legally Authorized for Employment in the United States?

Employment History

Previous Employer #1

Position

Start Date

End Date

Have You Ever Been Fired, or Asked to Resign, From a Job? If Yes, Please Explain Why?

Reference #1

Phone

CV/Resume

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Previous Employer #2

Position

Start Date

End Date

May We Contact Your Previous Employers?

Reference #2

Phone

Previous Employer #3

Position

Start Date

End Date

Have You Ever Worked at SGC Dental Staffing LLC ? If Yes,When?

Reference #3

Phone

Educational Background

Highschool Attended

Did You Graduate? If Yes, What Year?

College Attended

Did You Graduate? If Yes, What Year?

Trade School Attended

Did You Graduate? If Yes, What Year?

Questionnaire

Position You are Applying For?

Are You Seeking Permanent, Temporary, or Part-Time?

Permanent

Temporary

Part-Time

Availability?

Can You Perform the Essential Functions of the Job For Which You are Applying for With or Without Reasonable Accommodation?

Are You a Certified Surgical Technologist?

Please Upload a Photo of Your Certificate

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Are you Willing to Travel?

Are You a Certified Physician Assistant?

Please Upload a Photo of Your Certificate

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Which States are You Licensed in?

Are You a Registered Nurse?

Please Upload a Photo of Your Certificate

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Please Describe Your Clinical Skills in Instrument Handling, Suture & Wound Care, Anesthesia Assitance, & Preperation & Positioning?

Please Describe Your Technical Skills in Operating Room Protocol, Equipment Handling, and Endoscopic Assistance?

Thank you! We’ll be in touch.

SGC Staffing LLC

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APPLY ONLINE

Surgical Assistant

Come Work With Us

Contact Information

Background Check

Employment History

Educational Background

Questionnaire

SGC STAFFING LLC