Bexar County Medical Society Staffing Service

EMPLOYMENT APPLICATION

Thank you for taking the time to complete our online employment application. Please fill out the application below as completely as possible. This application will take approximately 15 minutes to complete.

Personal Information
Are you at least 18 years of age and do you have the legal right to work in the United States?
Yes No
Are you willing to take a drug test?
Yes No
First Name (Required)
Middle Name
Last Name (Required)
Nickname / Preferred Name
Street Address / Apartment  
City
State / ZIP Code    
Home Phone (Required) - Area code and phone number
Other Phone - Area code and phone number
Email Address
Resume - If you have a plain-text resume, paste it into the box below.
 

Availability
Are you willing to work temporary?
Yes No
Are you looking for a full-time career position?
Yes No
Are you looking for contract positions?
Yes No
When are you available to start?      
What weekday hours are you available?
What weekend hours are you available?
How many hours are you willing to work in a week?  
Are you willing to work overtime?
Yes No
What is the minimum pay you desire? Hourly rate or annual salary
How much notice will you need if a position is offered to you?
How many miles are you willing to travel to a position?
What kind of job are you looking for?

Education
Enter most recent - Do not enter start and end date if the most recent is high school
Name of School
Type of school  
Street Address
City
State / ZIP Code    
Start Date (Month / Year)    
End Date (Month / Year)    
Degree  
Major Study Area
Other Studies

Recent Employment
List most recent first
Company Name
Street Address
City
State / ZIP Code    
Supervisor Name
Job Title
Job Duties
Start Date (Month / Year)    
End Date (Month / Year)    
Start Wage Hourly rate or annual salary
End Wage Hourly rate or annual salary
May we contact this employer for a reference check?
Yes No
Company Name
Street Address
City
State / ZIP Code    
Supervisor Name
Job Title
Job Duties
Start Date (Month / Year)    
End Date (Month / Year)    
Start Wage Hourly rate or annual salary
End Wage Hourly rate or annual salary
May we contact this employer for a reference check?
Yes No
Company Name
Street Address
City
State / ZIP Code    
Supervisor Name
Job Title
Job Duties
Start Date (Month / Year)    
End Date (Month / Year)    
Start Wage Hourly rate or annual salary
End Wage Hourly rate or annual salary
May we contact this employer for a reference check?
Yes No

Enter the number of years of experience for each skill. Leave blank if no experience.
Faxing
Mail
Alpha
Numeric
Answer up to 3 phone lines
Answer up to 5 phone lines
Answer up to 10 phone lines
Phones 10 plus lines
PBX/Switchboard
Schedule Appts. Manually
Schedule appts. Computer
Schedule Surgeries
Check patients in only
Check patients out only
Collect Co-Pays
Balance - End of Day
Pulling Charts
Charting
Electronic
Utilization Review
Quality Assurance
Chart Review
Release of Information
Typing
Data Entry -Alpha
Data Entry - Numeric
485's
486's
Transcribing with dictaphone
Transcribing from written notes
Transcribing with heavy accents
Excel 7.0
Excel 97
FoxMed
Ivy
Lewis
Lotus 1-2-3
MS Word 7.0
MacIntosh
Mars
Med Manager
Meds America
Medic
Medisoft
MOMS
Quatro Pro
Quicken
Quick Books
Reynolds & Reynolds
Tri-Med/Integrity
Windows 95
Word Perfect 5.1 Dos
Word Perfect 6.0 Dos
Word Perfect 6.0 Windows
WordPerfect 7.0
Word Perfect 8.0
Versyss
Access 7.0
Access 97
Powerpoint 7.0
Powerpoint 97
Marketing
Ordering Supplies
Public Relations
Shorthand
Taking Minutes
Travel Arrangements
Acupuncture
Assess
Case Report Forms
Clinical Trials
Consent
Collect
Presentation
Data Verify
Record
Laboratory Specimens
Methodology
Patient Care
Patient Monitoring
Patient Enrollment/Recruiting
Protocol
Regulatory Documents/FDA
Report Preparation
Drug Studies