Whitepost Nursing Agency Ltd
Professional Placement
Client Requirements (Form B)

You may submit this form on-line, or print it and mail or fax it to us.
(If you run out of typing room in any field below, additional space is provided at the end of this form for your comments)


Client name:

Client address:

Your Title:

Phone number(s):

Email address:


We require employees in with the following specialties (please tick the following):

RGN RMN RMNH HCA Careworker Activities Organizer OT

Other: (i.e., intensive care, neonatal nursing, administrative, etc.)

Length of time employee(s) needed:

1 week 1 month 3 months 6 months

Permanent position Temporary Position

Do you require knowledge of a foreign language? If so, specify which language and level.




Do they have to be registered with the NMC? Yes No

Are you willing to provice Accommodatioon? Yes No

If posting or faxing, please return this form to
The Whitepost Nursing Agency Ltd
The Archway, Whitepost Health Care Centre
Shrewsbury Rd., Redhill, Surrey, RH1 6YY
Tel: 44 1737 772979 - Fax: 44 1737 772979

How did you hear about WhitepostHealthCare.com?
Search engine

Which search engine? Or other source?

Your message:


Thank You

© 2001. Whitepost Nursing Agency Ltd. -- All rights reserved.

Whitepost Nursing Agency Ltd
The Archway, Whitepost Health Care Centre

Shrewsbury Rd
Redhill, Surrey. RH1 6YY
Tel: 01737 779411
Fax: 01737 779411

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