Physician - Diagnostic Swing (4p-1a EST) 7 on 7 off / Teleradiologist (Hospital Reads) - FL License

Full Name

Contact Information (Phone, Email)

Current Location (City, State) + Time Zone?

Active Board Certification (ABR / ABNM / Other)? + any other certs like CAQ/MQSA etc

Medical Degree Type (MD or DO)?

Fellowship Training (Subspecialty + Year of Completion)?

Experience since graduating residency

Primary Specialty:

Radiology: Diagnostic/General Radiology
Radiology: Breast Imaging
Radiology: Neuro
Radiology: MSK
Radiology: Vascular/interventional
Radiology: Pediatric
Radiology: Nuclear Medicine
Radiology: Body Imager
Radiology: Cardiac /Cardiothoracic Radiology

Current Work Environment

Onsite Only
Onsite and Telemedicine Combo
Telemedicine Only

Modalities Comfortable With (CT, MRI, US, Mammo, PET, Fluoro, Procedures, etc.)

Average Daily Case Volume Comfort Level

Experience with Teleradiology Platforms (list systems, e.g., PowerScribe, PACS, Nuance, vRad, etc.)

Preferred Monthly schedule Format(s):

7on / 7 off
7 on / 14 off
M-F Full time
No scheduled shifts (Per Click)
Part time Ongoing

Currently interviewing anywhere else -or- current offers in hand?

Are you comfortable reading overnight or after-hours shifts?

Are you comfortable reading some weekends?

Are you comfortable getting a new license or two, if needed?

Current Employment Status (Full-time, Locum, Per Diem, Unemployed)

Desired Work Type (Locums, Permanent, Remote/Telerad, Hybrid, On-site)

Preferred Shift Types (Day, Evening, Overnight, Weekend) *

Desired Weekly Hours -or- # of per click reads

Earliest Available Start Date (Is there a company notice required?)

Any Planned Time Off in the Next 6 Months or Travel Plans

Desired Pay Rate (Hourly / Daily / Annual)

Preferred Payment Method (W2 / 1099 / Corp-to-Corp)

Preferred Facility Type (Hospital, Imaging Center, Academic, Private Practice, Teleradiology)

Case Mix Preference (General vs. Subspecialty-Focused) Ex. 60% MSK vs 40% Spines

Have you ever been subject to any board actions, license restrictions, or malpractice claims? (Yes/No; explain if yes)

Malpractice History *

1 or more "Settlement Pay outs" in my entire career as a physician
1 or more dismissed cases in my entire career as a physician
1 or more pending cases in my entire career as a physician
No malpractice settlement pay outs, no pending cases, no license actions, and no dismissed cases in my entire career as a physician

Will you consent to background and credentialing checks? (Yes/No) *

What are the top 3 things most important to you in your next position?

How did you hear about us?

Anything else we should know to find your ideal opportunity?

Active State Medical Licenses *

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