Let’s work together

Interested in working together? Fill out our application and we will be in touch shortly! We can't wait to hear from you.

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

List Certifications and Certifying Agencies for Each:

Are You a US Citizen?

Yes

Are You Authorized to Work in the US?

Yes

Have you ever been convicted of a felony or any crime pursuant to 42 U.S.C § 1320a-7(i) or been subject to any exclusion action by OIG/Medicare/Medicaid? If yes, explain:

Have your Medical/Nursing privileges ever been restricted or revoked? If yes, explain why:

College/University:

Degree Obtained:

Please List Your Job History Relating to This Position. Include Position, Dates, and Company Name.

Please List 3 References, Include Name, Phone Number, and Email Address.

I certify that all of the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected, and if I am employed, my employment may be terminated at any time. In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation may be terminated, with or without cause, and with our without notice, at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with our without cause, and with or without notice, at any time by the company. I understand that no company representative, other than its President, and then only when in writing and signed by its President, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing.

Come work for PHG!

Join our team of dedicated healthcare professionals, where your expertise will be valued and your skills honed through ongoing professional development. As a provider with PHG, you will have the chance to make a real difference in the lives of individuals and communities, providing preventive care, managing chronic conditions, and promoting overall wellness. Apply to join our team today, where we are always welcoming new physicians and Nurse Practitioners!