Form preview

Get the free LOCUM TENENS APPLICATION

Get Form
This document serves as a formal application for locum tenens coverage which requires detailed information from both the insured and the locum tenens, including personal details, coverage requests,
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign locum tenens application

Edit
Edit your locum tenens application form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your locum tenens application form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing locum tenens application online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Follow the steps below to use a professional PDF editor:
1
Log into your account. It's time to start your free trial.
2
Prepare a file. Use the Add New button to start a new project. Then, using your device, upload your file to the system by importing it from internal mail, the cloud, or adding its URL.
3
Edit locum tenens application. Rearrange and rotate pages, add and edit text, and use additional tools. To save changes and return to your Dashboard, click Done. The Documents tab allows you to merge, divide, lock, or unlock files.
4
Get your file. Select your file from the documents list and pick your export method. You may save it as a PDF, email it, or upload it to the cloud.
With pdfFiller, it's always easy to deal with documents.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out locum tenens application

Illustration

How to fill out LOCUM TENENS APPLICATION

01
Obtain the locum tenens application form from the relevant agency or organization.
02
Fill out your personal information, including name, address, and contact details.
03
Provide your medical license information, including license number and state of issuance.
04
Detail your educational background and any specialized training or certifications.
05
List your work history, including previous locum tenens positions and any relevant clinical experience.
06
Include references, which may be required from colleagues or supervisors who can attest to your qualifications.
07
Complete any additional sections, such as malpractice history or background checks.
08
Review the application for accuracy and completeness before submission.
09
Submit the application according to the agency's instructions, either online or via mail.

Who needs LOCUM TENENS APPLICATION?

01
Healthcare providers seeking temporary work in a different location.
02
Physicians or nurses wanting to fill in for absent staff in various healthcare settings.
03
Facilities in need of personnel to cover shortages or maternity leaves.
04
Healthcare agencies that match locum tenens professionals with facilities.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.0
Satisfied
48 Votes

People Also Ask about

A locum, or locum tenens, is a person who temporarily fulfills the duties of another; the term is especially used for physicians or clergy. For example, a locum tenens physician is a physician who works in the place of the regular physician.
Locum tenens is Latin word that means “to hold the place.” In modern healthcare, a locum tenens provider is a physician or advanced practice provider who fills in for another clinician while they are unavailable. The locum tenens industry was established in 1979 to help fill physician staffing gaps in rural locations.
Locum tenens refers to providers and physicians work at healthcare facilities to fill gaps in care or occupy vacant positions on a temporary basis, though the positions can be short-term or long term.
Full-Time Locum Tenens Earning Potential by Specialty SpecialtyHourly RateFull-Time Locum Tenens Critical Care Physicians $190 – $265 $473,200 Cardiologists Up to $2,500/day $611,000 CRNAs $150 – $200 $204,000 Dermatologists $150 – $250 $416,00015 more rows
In a hospital setting that requires privileges, the locum tenens credentialing process can take anywhere from 30 days to six months, with 60-120 days being most typical, ing to Waldrop. Some hospitals have emergency privileging which can allow a provider to start before the full process is complete.
Full-Time Locum Tenens Earning Potential by Specialty SpecialtyHourly RateFull-Time Locum Tenens Critical Care Physicians $190 – $265 $473,200 Cardiologists Up to $2,500/day $611,000 CRNAs $150 – $200 $204,000 Dermatologists $150 – $250 $416,00015 more rows

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

Locum tenens application is a process in which healthcare professionals, particularly physicians, can apply for temporary positions to fill in for other medical staff, ensuring that healthcare services continue uninterrupted.
Typically, healthcare providers such as physicians, nurse practitioners, and physician assistants who wish to take short-term assignments in different practices or facilities are required to file a locum tenens application.
To fill out a locum tenens application, applicants must provide personal information, professional qualifications, licensing details, and any necessary supporting documents. It's advisable to follow the specific instructions provided by the practice or agency where the application is being submitted.
The purpose of the locum tenens application is to ensure that qualified healthcare providers can be matched with temporary positions to maintain continuity of care during staff shortages, vacations, or other absences.
Typically, the information required includes personal identification, medical licenses, educational background, work history, any malpractice history, and references. Specific requirements may vary by state and facility.
Fill out your locum tenens application online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.