Radiology Staff Request Form

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Thank you for your interest in Dependable Staffing Services! Use this form to place a Staff Request and one of our Expert Coordinators will contact you shortly. Of course you can always contact us immediately by phone to place an order 24/7 at 602-264-1444.

	Client requesting staffing services*

	Client address where staffing services are to be provided*

	Position Requested*

	Client representative placing the request for services*

	Client representative phone number*

	Client representative email address - A copy of the request will be forwarded*