Form: APRN Intake

APRN Directory Intake
we will need to call you when an attorney wants to hire you
Do you consent to text messages for communication?
You will need to have your professional headshot and your CV/resume available prior to proceeding.

Maximum file size: 33.55MB

0 of 150 max words
0 of 700 max words

Terms and Condition

Social Links

Optional. if none

Consultant's Credentials

Please indicate all degrees obtained in healthcare-related education
Please indicate all certification(s) obtained
Please select ALL specialties in which you have at least TWO years PROVIDER-level experience
Are you interested in/willing to testify?
This is not required, but many NPs can charge upwards of $200/hr for testifying work.
This means had a deposition taken under oath outside of a courtroom. If none, please indicate "0"
If none, please indicate "0"


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