Credentials - Vitawerks New

Empowering Healthcare Professionals Nationwide

First Name*

Last Name*

Mobile Number*

Email*

Address*

State *

I am a *

Enter Valid License Number*

Resume

Upload Physical Test (within last year)

Upload TB Test or Chest X Ray (within last year)

Upload CPR/BLS Card

Upload Driver's license or State ID

Upload Social Security Card

Proof of Medical Insurance, Liability Insurance or Workers Comp

COVID Vaccine Date - Latest Shot

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