Registration
Interest Form

Dear Candidates,

Thank you for your interest in Obsidian Healthcare Recruitment. We have a wide range of temporary positions available across the UK and offer industry-leading benefits in return for working with us. You’ve made the first step in pursuing a new beginning by considering joining the Obsidian Family. Please complete the short form below, and one of our consultants will be in touch to assist you in the registration process.

Name

First Name

Last Name

Contact number

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Profession

Band

Speciality

Professional Registration

If you selected "Other" please specify

Professional Registration Pin

Are you substantively employed elsewhere in the NHS or Private Sector?

Yes

If yes, at which Organisation/Hospital?

Are you full time agency?

Yes

Please list the locations you have worked agency shifts at in the last 6 months.

How many shifts are you availlable to work each week?

Do you work days or nights?

How did you hear about Obsidian Healthcare?

I accept the terms of your privacy policy.

Registration Interest Form

Dear Candidates,

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Registration
Interest Form