Request for Physician Recruitment Assistance
 

If request is for a private practice opportunity, Providence will work within approved regulatory guidelines relative to support in communities we serve where there is either a Providence or community need. Please fill in this form completely regarding your practice opportunity; this will help us advertise to recruit the best possible candidates for you!

Requestor Name: *    
Requestor E-Mail: *  
Date of request: *     
Requestor Dept. / Group Name: *    
Specialty / Job Title: *  
City: *    
Location of Physician/Group Practice: *  
PH&S Entity where physician will have privileges: *

Alaska

California

Montana

Oregon

the West

Washington
Practice Model: *  
FTE (Full time is 1.0 FTE, half time is 0.5 FTE, etc.)*    
For PH&S-employed opportunities in Alaska, California, Oregon and Western Washington, please provide your 8-digit PH&S department code:  
Call Ratio:    
Compensation range:    
Target start date:   
Position Type:*
Brief practice description:
 
 
Special skills needed (bilingual, leadership, special procedures, etc.):
 
 
Suggestions for tactics to promote the opportunity:
 
 
Hiring Administrator:
Name: *
Phone:
Extension:
Lead Physician:
Name: *
Phone:
Extension:
 
All the fields marked (*) are required fields
 
Questions? Call John Roscoe at 503-216-5446 or e-mail: John.Roscoe@providence.org