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Nursing Staff Request  
Register your staffing requirements here

Complete the registration form below and we will find the perfect nurse for you.

 Nursing Staff Request Form
1. Contact Details
Name of Facility
Person Requesting Service
Designation within the Service
2. Staffing Requirements
Staff Required Numbers Required
Nurse Management (level):
Registered Nurse
Endorsed Enrolled Nurse
Enrolled Nurse
3. Skills Required
With the following skills
Rural - Generalist - Snr OT/Recovery
Rural - Generalist - Jnr Endoscopy
General Hospital General Practice
RAN RAN Sole Practitioner
Nurse Practitioner Aged Care
Midwife Sexual Health
Mental Health Endorsed Infection Control
Mental Health Rehab Forensic Mental Health
Child and Youth Mental Health Inpt Mental Health
Community Mental Health HDU
Drug and Alcohol Renal
A & E Wound Care
Surgical Diabetes
Medical Respiratory
Paediatric QA
Orthopaedic Occupational Health & Safety
Coronary Care Cardio thoracic Care
Intensive Care CSSD
Immunisation Programs Endorsement Primary Health Care
Community Child Health Nurse
Public Health  
Other skills desired  
4. Placement Dates
Dates Required
If you need the staff As Soon As Possible, simply check the ASAP checkbox below instead. If you are unsure of the Finish date, simply check the ALAP (As Late As Possible) checkbox.
Start Date:
Finish Date:
5. Immediate Start Required?
Start ASAP Finish ALAP
6. Placement Type
7. Contact Preference
  Preferred Contact Method
State Post Code
8. Subscribe to our Facility Newsletter?
Would you like to receive a monthly newsletter, which will include current changes to health care, a preview of available nurses and their skills, and up and coming educational opportunities for nurses.
9. Validation
Validation Step 1
Before submitting your enquiry, type the two words displayed below into the field where prompted. If you cannot read the words, click the red arrows to display new words.
Validation Step 2
To obtain the final Submission code, click the Get Submission Code button, enter the required word into the Submission Code field, then Click the Submit Button.
Enter Submission Code Here
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