Candidate Document submission form and Checklist

Welcome! Please review the following checklist carefully. To be officially submitted for consideration at our healthcare partner facilities, we require the initial items in Section A immediately. The items in Section B are not required now but will be essential if you are selected for the position. Providing them early can significantly speed up your onboarding process later. The facility will collect the items in Section C.

Section A: Required for Submission (Submit Now)

These documents are mandatory to present your profile to our client facilities for an interview.

• Professional License/Certification Verification: A clear copy of your current, active license (e.g., RN, LPN, CNA, MD). Please ensure it is not expired.

• Social Security Number (SSN): For required pre-screening/Background checks.

• Skills Checklist: A link will be emailed or Choose the applicable Checklist below

• Resume

Pharmacy Manager Skills Checklist

Surgical Tech Skills Checklist

Section B: Required Post-Offer (Highly Recommended to Gather Now)

If selected for the position, you will be required to complete the following for your background check and facility onboarding. You can begin gathering these items now.

Background & Identity:

• Driver's License or State ID: A clear, front-and-back copy.

• Social Security Card: A clear copy (or you may provide it in person for verification).

• McLeod Profile

• McLeod Employment Verification: A form they need to sign authorizing the check

Clinical/Health (Will be collected/processed by the facility):

• Proof of Vaccinations or Immunity: (You may already have records for these)

  • COVID-19 Vaccine

  • MMR (Measles, Mumps, Rubella)

  • Hepatitis B

  • Varicella (Chickenpox)

  • Influenza Vaccine (Seasonal)

• TB Test Results:

  • Positive PPD with corresponding Negative Chest X-Ray OR

  • Negative 2-Step PPD OR

  • Negative IGRA Blood Test (Quantiferon or T-Spot)

Section C: To Be Completed with the Facility

The following items will be arranged, completed, and collected by the healthcare facility after you accept an offer. You do not need to provide these now.

• McLeod Drug Screen

• McLeod Criminal Background Check Results (initiated after you sign authorization)

• McLeod Confirmation of Assignment

• Personal Health History Form

• Fit Test (for N95 respirator mask)

• Covid Test (if required)

• Annual Negative PPD / Annual TB Questionnaire