CLINIC TRIAGE & CLARITY SESSION FORM

SHYFT Agency - Clinic Triage & Clarity Form

First Name *

Last Name *

Phone *

Email *

Address

Street Address

City

State

Country

Postal Code

Consult Type

Your Role

What type of consultation are you seeking?

Current pressure point

Staffing snapshot - Is your clinic currently considering hiring?

Which best applies right now?

Experience Requirements

What are you hoping to get out of this consultation?

Have you worked with a consultant, mentor, or recruiter before?

Yes

No

Privacy Policy | Terms & Conditions | Compliance Responsibilities

By submitting this booking request, you acknowledge and agree to SHYFT Agency’s Terms & Conditions, Privacy Policy, and Compliance & Clinical Responsibilities. All temporary staffing services must be paid upfront before confirmation.

You also consent to receive transactional messages related to this booking. You may opt out of marketing communications at any time.

I understand and agree

I agree to the above

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Ready to Join Us?

We are selective because we believe in quality and fit.
If you’re ready to be part of a boutique, caring, high-standard agency, we’d love to hear from you.