Sunday, February 26, 2017

North Carolina Employee's Withholding Allowance Certificate (NC-4 Form)
Minimize

North Carolina Department of Revenue - Employee's Withholding Allowance Certificate

Electronic Forms for Completion, Digital Signature and Submission:

Download PDF Format

NC-4 EZ Employee's Withholding Allowance Certificate [Short Form] (EchoSign) PDF Format
NC-4 Employee's Withholding Allowance Certificate  [Extended Form] (EchoSign) PDF Format

 


Print  

Facility Specific Forms
Minimize
Broughton Hospital – Morganton, North Carolina

Forms for Completion, Digital Signature and Submission:

Download PDF Format

Broughton Self Test - Competency (EchoSign)

PDF Format

Broughton Self Test - Pain Management (EchoSign)

PDF Format
Broughton Health Care Technician Test (Online Form) PDF Format
DHHS Criminal Record Check Consent Form and Release of Information (EchoSign) PDF Format
Required Influenza Vaccination Policy and Attestation (EchoSign) PDF Format
Timesheets: 

Timesheet for Broughton Hospital Nurses

PDF Format
Timesheet for Broughton Hospital Certified Nursing Assistants / Health Care Technicians PDF Format
Nurses will be tested on the following document: 
Medication Administration Education Program PDF Format

 

Central Regional Hospital – Butner, NC

Forms for Completion, Digital Signature and Submission:

Download PDF Format

DHHS Criminal Record Check Consent Form and Release of Information (EchoSign) PDF Format
Required Influenza Vaccination Policy and Attestation (EchoSign) PDF Format
Application for Exemption to Annual Influenza Vaccination PDF Format
Adverse Weather Policy (EchoSign) PDF Format
Compact License Form (EchoSign) PDF Format
Timesheets: 
Timesheet for Central Regional Hospital Nurses PDF Format
Timesheet for Central Regional Hospital Certified Nursing Assistants / Health Care Technicians PDF Format
Documents to Review: 
Compliance Checklist PDF Format
Memo Regarding Levels of Observation PDF Format
Nurses will be tested on the following two documents:
Basic Concepts in Psychiatric Nursing PDF Format
Medication Administration Education Program Study Guide PDF Format

 

Cherry Hospital – Goldsboro, NC

Forms for Completion, Digital Signature and Submission:

Download PDF Format

Cherry Hospital Professional Nurse Job Description (EchoSign)

PDF Format

Cherry Hospital Health Care Technician I Job Description (EchoSign)

PDF Format

Cherry Hospital Interview - Nurses (Echosign)

PDF Format
Cherry Hospital - Health Care Technician Pre-hire Questions (Echosign) PDF Format
DHHS Criminal Record Check Consent Form and Release of Information (EchoSign) PDF Format
Required Influenza Vaccination Policy and Attestation (EchoSign) PDF Format
Timesheets:
Timesheet for Cherry Hospital Nurses PDF Format
Timesheet for Cherry Hospital Certified Nursing Assistants / Health Care Technicians PDF Format
Nurses will be tested on the following two documents:
Basic Concepts in Psychiatric Nursing PDF Format
Medication Administration Ecuation Program Guide PDF Format

   

Murdock Developmental Center - Butner, North Carolina

Timesheets:

Download PDF Format

Timesheet for Murdock Developmental Center Nurses PDF Format
Timesheet for Murdock Developmental Center / Health Care Technicians PDF Format

  

R.J. Blackley, A.D.A.T.C. – Butner, NC

Electronic Forms for Completion, Digital Signature and Submission:

Download PDF Format

Registered Nurse Job Description (EchoSign)

PDF Format

Licensed Practical Nurse Job Description (EchoSign) PDF Format

Health Care Technician I Job Description (EchoSign)

PDF Format

Checklist for Physical Activities and Requirements, Visual Acuity, and Working Conditions (EchoSign)

PDF Format 

Employee Immunization and Communicable Disease Screening Form (EchoSign)

PDF Format

DHHS Criminal Record Check Consent Form and Release of Information (EchoSign) PDF Format
Certified Nursing Assistant - Additional Skills Acknowledgment Form (EchoSign) PDF Format
Required Influenza Vaccination Policy and Attestation (EchoSign) PDF Format
Identification and/or Address Update Form (EchoSign) PDF Format
Personnel Profile Form (EchoSign) PDF Format
Emergency Notification Form (EchoSign) PDF Format
Timesheets:
Timesheet for R.J. Blackley Nurses PDF Format
Timesheet for R.J. Blackley Certified Nursing Assistant / Health Care Technicians PDF Format
Nurses will be tested on the following two documents:
Basic Concepts in Psychiatric Nursing PDF Format
Medication Administration Ecuation Program Guide PDF Format

 

Walter B. Jones, A.D.A.T.C. – Greenville, NC

Electronic Forms for Completion, Digital Signature and Submission:

Download PDF Format

Registered Nurse Banded Position Description (EchoSign)

PDF Format

Health Care Technician I Job Description (EchoSign)

PDF Format

Health Care Technician I Specifications (EchoSign)

PDF Format 

DHHS Criminal Record Check Consent Form and Release of Information (EchoSign) PDF Format 
Timesheets:
Timesheet for Walter B. Jones Nurses PDF Format
Timesheet for Walter B. Jones Certified Nursing Assistant / Health Care Technicians PDF Format

 


Print  

Privacy Statement  |  Terms Of Use
Copyright 2008 by Worldwide Travel Staffing, Ltd.