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Staffing Request Form

When staffing needs are a priority, we can assist in providing timely placements. To help expedite the process, please complete and submit this brief form. We will contact you within 24 hours (Monday – Friday). If you have any questions, call Allied Health Professionals at (847) 266-1300, or email us at
  • If you have specific Candidates you would like to consider, please list their IDs here.