Recruiting Request Form

Do you need a Sonographer or Medical Professional? Please complete the following fields and click on SEND, or call us at 860-666-ECHO,
or toll free at 866-558-ECHO

First name

M.I.

Last Name

Credentials

Practice or Organization Seeking Staff
Contact Information (please check the preferred contact number)

Address line 1

Adress line 2

City

State

Zip code

Email address

Day phone

Cell phone

Evening phone

Discipline Needed

Cardiac Sonographer

OBGYN Sonographer

Vascular Sonographer

Abdominal Sonographer

Cerebral Sonographer

Physician

PA

Nurse

Surgeon

Surgical Assistant

Other (required certifications)

Please check the categories that apply

Temporary employee

Permanent employee

Full time

Part time

If Temporary/Durational

Length of assignment

Estimated start date

Estimated end date