Nurses Plus Hospice Inc.
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For interested parties, kindly fill-up the form below . You may also contact us at (562) 809-1192 or email us at
hospice@nursesplusinc.com
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Personal Information
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Legal Information
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Have you ever been convicted of a felony?
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Have you ever been a defendant in a malpractice lawsuit?
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Have you ever been denied Fidelity coverage?
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YES
NO
If you answered YES to any of the above three questions, please state your reason below:
License Information
Full name appearing on professional license:
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License type:
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RN
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