Following are documents that many of our nurses need to access in order to keep their profiles current and to communicate with us.  Fax us completed documents at (215) 750-7592.

Documents are available in Adobe Acrobat PDF Format or Microsoft Word DOC Format, or both.  Please feel free to click on the desired format and download any of these documents and mail, fax, or e-mail them back to PRN Consultants.

Web related content can be accessed by clicking the symbol where applicable.

The Adobe Acrobat Reader is required to view PDF files and Microsoft Word is required to view DOC files.  Click on the following links to download and install them if needed.

PRN Nurse Applications* (Mail or Fax)

PDF	DOC	Web	Description
			PRN Pennsylvania Nurse Application
			PRN New Jersey Nurse Application

*In addition to the interview and application, all nurses applying to PRN Consultants should also provide the following items listed on the RN Requirements page.

Nurse Profile Documents

PDF	DOC	Web	Description
			I-9 Employment Eligibility Verification Form
			W-9 Request for Taxpayer Identification Number and Certification Form
			HIPAA Statement (Confidential Health Information) Form
			Yearly Inservice Programs Form
			Yearly Physicians Statement Form
			Fit Test Form
			Titer Declination Form
			Reference / Evaluation Form

Criminal Clearance Documents

PDF	DOC	Web	Description
			Pennsylvania State Police Request for Criminal Record Check (Mail)
			Pennsylvania Access to Criminal History (PATCH - Online)

Direct Deposit Authorization Documents

PDF	DOC	Web	Description
			Pennsylvania Direct Deposit Agreement (Include Voided Check)
			New Jersey Direct Deposit Agreement (Include Voided Check)