Coastal Clinical & Management Services, Inc.  

Dedicated to Serving our Active and Retired Troops and their Families

Employee Checklist
(Print and use as a guide when completing your packet)

1. Please include the following information in your packet:
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Photograph: Original, recent Polaroid or passport photo. If you are coming in for an interview, we can take a photograph for you.
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Diploma/Degree: Copies of diploma and/or degree(s). If you do not have, or cannot get copies of, your diploma/degree(s), please complete the "Educational Statement" .
bullet Professional License(s): Copies of ALL current professional licenses and any license you have held in the past 5 to 10 years.
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CPR Certification: Must be American Heart Association Course C or American Red Cross Certification for the Healthcare Professional.
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ACLS Certification: Required for ER,ICU, Tele and PACU nurses. If you do not have current ACLS certification, it must be obtained prior to your start date. We will need a note stating the date, time and location of your course.
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PALS Certification: Required for ER, Peds, NICU, PICU, Nursery.
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NRP Certification: Required for Maternal Child and Labor and Delivery departments. Preferred in ER.
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Proof of US Citizenship: Acceptable forms of ID include copy of unexpired US passport, birth certificate, or Alien Registration card, state driver’s license and SSN card.
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Professional Certifications:  i.e. CEN, CCRN, TNCC
 
2.Applicants must complete all the following forms, which have been  provided for you on this web site. Please click on the titles below:
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I-9: Required for proof of US Citizenship. It is required for all applicants. 

bullet Physical: Evidence of physical within thirty days of hire which includes PPD, Varicella, MMR for persons born 1957 or later, and hepatitis-B vaccination. If you have not had Hepatitis-B vaccination and do not wish to get it, please complete a Hepatitis-B Vaccination Waiver.
bulletApplication Form: Complete and submit this form on line. 
bullet Signature Forms: These forms must be completed by all applicants. Please print, sign and fax a copy, and mail the original.
bullet Work References:  List three professional references; two of which should be former (or current) supervisors. Please provide current phone numbers.
bullet Voluntary Self Identification:  Voluntary form helps the Federal Government track their veterans in the workplace to prevent discrimination.
bullet W-4: To be completed after hire.
bullet Direct Deposit: To be completed after hire.
bullet Skills Check List: For Specialty (If applies).

Emergency Room     Medical Surgical     Intensive Care     Labor & Delivery     Mother Baby

Medical Assistant     Pharmacy Tech     OR Technician     Neonatal ICU      OR RN     Nursing Assistant

 

After completing the application, you may choose one of the following:

Email to Toni@CCMSstaffing.com, or

Fax to (610)667-2025, or
Mail to:      CCMS
                  Toni Pettineo, RN
                   Director of Recruitment
                        33 Rock Hill Road, Suite 350
                   Bala Cynwyd, PA 19004

 

33 ROCK HILL ROAD, SUITE 350, BALA CYNWYD, PA 19004

(P) 610-949-9210      Toll Free 877-456-3579
(F) 610-667-2025      Toll Free 866-204-8764
A Small Woman-Owned Healthcare Staffing Company Dedicated to Serving our Active Duty Troops, their Families and Retirees