the perfect find

Employer Registration / Staff Requirements

Register your staffing requirements with CQ Nurse on the Employer Registration Form below, let us know a suitable time to call and we'll get in touch with you.

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

Name of Facility

Person Requesting Service

Designation within the Service


Staff Required		Numbers Required
Nurse Management (level):
Registered Nurse
Endorsed Enrolled Nurse
Enrolled Nurse

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


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.
To START: To FINISH:

Immediate Start Required?
To Start ASAP To Finish ALAP

Placement Type


Contact Preference
Preferred Contact Method

Phone
Fax
Email
Address
State	Post Code

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Note About Submitting Request
Before submitting this form you must enter the two words displayed below into the field where prompted. If you cannot read the words, click the red arrows to display new words.


Ready To Submit This form?
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Enter Submission Code Here

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