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Permanent Placement- AOC
Please provide the following information in order for us to find you the best fit for your practice
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Office Name
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Your answer
City and Zip code
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Your answer
Contact Name
*
Your answer
Contact email (preferred email for all correspondence for permanent placement)
*
Your answer
What type of employment are you seeking? (check all that apply)
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Front Desk
Office Manager
Dental Assistant
EDDA
RDH
DDS
Required
Ideal personality:
*
Your answer
Clinical skills preferred/required?
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Your answer
Please check all that apply for the position:
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Paid holidays
Retirement match
Medical benefits
Dental benefits
Vision benefits
Required
Other information (i.e. days preferred, hours, bonus opportunities etc.
*
Your answer
Please acknowledge that if you decide to move forward with
Assistance On Call, the Dental Staffing Company,
helping you hire our fee is 10% of the new hire’s gross annual income. This can be broken into 3 payments, and paid via check, credit card or ACH)
TYPE FULL NAME BELOW AS DIGITAL SIGNATURE:
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Date of Digital Signature:
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