Medlinx Consultants, Inc.

The following documents are required to begin your process of employment with Medlinx consultants, Inc. consultants, Inc.

Last Name

First name

Middle name

Previous Surname

	Resume
	Application
	Summary of Professional Qualifications
	Release of Authorization Form (notarized) - if you, the therapist, are requesting licensing services
	3 Verbal References
	License & Certification Form

Copies of the following documents must be sent prior to your start date. Clients and we use these documents for credentialing verification. Without these items it is virtually impossible to obtain client acceptance for you as a therapist. Please send document copies that are dark and clear enough for us to reproduce legible copies that will be acceptable to licensing boards.

	CPR Certificate (current within the past year)
	Completed and signed Physician's Statement (must include Rubella titer and TB)
	School Diploma or Certification
	Certification: -ASHA (Speech Language Pathology) -NB COT (Occupational Therapy) -NBRC (Respiratory)
	Advanced Training Certificates (optional)
	State License(s) with most recent renewal card(s).
	Military Discharge Papers (Honorable Discharge Certificate plus DO214 Separation Paper) - if applicable
	Social Security Card and Drivers License or Birth Certificate or Passport
	Proof of Hepatitis B vaccination or Declination form
	Proof of OSHA blood borne pathogens and infectious disease training (current within the past year)
	PHOTOGRAPHS (optional, if you, the therapist, are requesting licensing services)

Pictures are essential in procuring new state licenses for you. Passport type photos are the most readily acceptable. These photographs should be signed and dated on the front.

LETTERS OF RECOMMENDATION (2)

Two letters are requested for your file. Each letter of reference should come from a different source. Colleagues with whom you have worked or trained within the past six months to a year should write these letters. These letters are also an integral part of the state licensing and client acceptance,