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Last updated on
December 09, 2008
 
Register Here (für deutsche Version hier klicken)
 
If you are interested to work as a nurse in the United States, please take a few minutes to register by filling out the form below.  Please see our privacy policy.

These information will help us to determine how we can best assist you to find work as a nurse in the United States.

Once we have received your information we will send you a username and password so you can access a protected part of our website which contains detailed information about the process to obtain the necessary credentials to work in the United States. 
 
Items marked with an asterisk* must be completed.
 
First and Last Name*
 
E-Mail*
 
Confirm E-Mail*
 
City
 
Country*
 
Phone Number*
 
I am a Citizen of*
 
Year of Birth
 
Gender*     Female    Male
 
Marital Status
 
Do you have any children under the age of 18 ?
Yes         No
 
Please tell us about your primary and secondary (high) school education
 
What type of secondary (high) school degree did you obtain ?*
 
How many years did your primary (grade) and secondary (high) school education last ?*

Please tell us about your nursing education

What kind of nursing school did you attend ?*
 
Name of nursing school*
 
What type of Nursing Degree did you earn (Diploma, Associates Degree, Bachelor of Nursing etc.) ?*
 
Do you have a degree as pediatric nurse ?
Yes      No
 
How many years did your nursing education last ?*
 
When did you obtain your nursing degree (year) ?*
 
In which country did you obtain your nursing degree ?*
 
Did you complete any advanced education/specialty courses in nursing ?  If yes, please tell us about them.
 
Please tell us if you hold any other degree in a field other than nursing
 
Field of degree
 
Years of work experience in other degree field
 
Please tell us about your work experience as a nurse
 
How many years have you worked as a nurse ?*
 
 
In which areas of the hospital have you worked in (ER, CC, IC etc.) and for how long in each area ?*
 
 
What is the total number of beds in the hospital you work ?*
 
What is the total number of beds in the unit you work ?*
 
What is the nurse to patient ratio in the unit you work ?*
 
How many patients are you been responsible for during your shift ?*
 
Please tell us about your efforts to obtain the necessary credentials to work as a nurse in the United States
 
Have you applied for a state nursing license in the United States ?*
  Yes        No
 
If yes, in which US state ?
 
Have you taken and passed one of the required English tests ?*
  Yes        No
 
If yes, which test ?
 
Have you submitted your nursing education for review with the appropriate US institution ?*
  Yes     No
 
If yes, at which institution ?
 
Was your education accepted as equivalent to that of a Registered Nurse (RN) in the United States ?
 
If no, please specify in further detail why not:
 
Have you taken the NCLEX-RN ?*
  Yes        No
 
If yes, have you passed the NCLEX-RN ?
  Yes        No
 
Do you have a valid  VisaScreen® Certificate or have you filed an application to obtain it ?*
  Yes         No
 
Do you currently have a valid license to work as a Registered Nurse (RN) in the United States ?*
  Yes         No
 
If yes, in which state US state ?
 
If yes, when does your license to work as a nurse in the US expire ?
 
Are you a citizen of the United States or do you have an immigrant visa (Greencard) ?
  US Citizen
  Immigrant visa (Greencard)
 
Have you ever worked as a nurse in the United States ?
Yes         No
 
If yes, where and in what capacity ?
 
Please tell us more about yourself
 
What is your motivation for wanting to work as a nurse in the United States ?
 
What are the most important considerations for you when deciding at which hospital to work ?
(working conditions, integration of international nurses, opportunities for continuous education and career advancement, initial salary, location of hospital etc.)
 
Have you ever lived in the United States for an extended period of time ?
(for example as a foreign exchange student in high school, college student, au-pair etc.)
 
How did you hear about European Medical Staffing ?
 
I agree with the terms and conditions regarding the use of this site*                      Yes    No

Thank you very much for taking the time to provide us with these information.

We will send you your username and password shortly.  We look forward to working with you !

 

     

 

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