Request staff

Submit a staffing request

Maryland Health Care Staff Agency · HCSA-01637 — temporary healthcare staffing support across Maryland.

1Organization information

Facility / organization name*Facility typeContact person*Job titleBusiness email*Business phoneFacility addressCityStateZIP

2Staffing need

Position needed*Number of workers neededDate neededCoverage typeShift start timeShift end timeUrgency

3Assignment details

Unit / programRequired credentialsDriving requiredPrimary dutiesAdditional instructions

Please do not include personal health information, diagnoses or identification numbers in this form.

This is a recurring staffing need

4Review and submitMy organization has vendor or billing details to share now

Submission of this form constitutes a staffing inquiry/request and does not guarantee coverage. Phillips Health Consulting LLC will review worker availability, applicable credentials, Client requirements, commercial terms and assignment details before confirming coverage.

I acknowledge and understand.

Questions? 667.367.4472