WHAT WE NEED FROM YOU-

• Resume
• Professional photo
• DL
• W9
• NBCRNA Certificate
• Fed DEA copy
• Anesthesia School Transcript
• Undergrad Transcript
• Legal history
• Immunizations Hep A&B, Tdap, MMR, Covid & Flu etc
• Declination forms
• Peer references, 2-CRNAs & 1 MD

WHAT YOU NEED TO APPLY FOR-

*Premier Providers will reimburse fees

• Board of Pharmacy CSA (IA $47 fee)
• Adult and Child abuse course (IA free)
• BON Application (IA $81 fee)

WHAT WE WILL GATHER FOR YOU-

• Nursys verification (RN compact license)
• NPI #
• Malpractice disclosures
• 10 year work history and COIs