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Application Materials

The following documents and licenses are required and must be on file for all employees. Please call us to schedule an appointment. We do not accept walk-in appointments.

Our application may be completed by selecting the "Apply Now" button below. All other forms may be downloaded by clicking
on their links.
Our OSHA, HIPAA and Skills Checklists are now administered by Prophecy Health. We will send you a link to complete these tests after you complete your interview. You must have the Acrobat Reader to view most of these documents. You may download the Acrobat Reader here.

Apply Now




1. Application Documentation:

2. Health Requirements

  • A physical or physicians statement from the past twelve months (annual requirement)
  • Hepatitis B Documentation (vaccination series, titer, or signed declination)
  • A TB test from the past twelve months or a recent Chest X-Ray (TB test is an annual requirement)
  • TB Questionnaire - Only complete this if you test positive for TB.
  • Proof of Immunity to Rubeola and Rubella and Mumps (positive titer or two MMRs within ten years)
  • Positive Varicella titer
  • Urine drug screen
  • Respirator fit test (this is an annual requirement and can be completed in our office)
  • Proof of Flu Vaccination (annual flu vaccination is required in order to staff at most hospitals).

3. Licenses and Certifications

  • A current Illinois or Indiana Nursing License or CNA Certification
  • A current CPR/ACLS card (only American Heart Association Cards are accepted)
  • NIH Stroke Scale Certificate (required for ER at Little Company of Mary Hospital )
  • Proof of eligibility to work in the United States (Social Security card and Driver's License or Passport or Birth Certificate)

All of the above items must be in your file before you will be permitted to work.

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10829 S. Western Avenue, Suite B, Chicago, IL 60643

Phone: (773) 779-8200 FAX: (773) 779-8866

EMail: info@thenurseagency.com

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