TEMPORARY JOB ORDER FORM

    Dental Staffing Solutions has been serving Pinellas, Pasco and Hillsborough Counties since 1994.  To put in your request for temporary help, complete the information below and submit.

    In consideration of Temporary Independent Contractor performance of their services.  The Dentist Contractor will pay by the day (including Independent Contractor Fee (hourly) and Agency Flat Fee).  There will be a Half Day Minimum charge for  cancellation of assignment with out 24 Hour notice.  

Name

Address: 

City, State, Zip: 

Phone Number: 

Email Address: 

 Position needed:

Dates  needed:

Your Office Hours:

Desired hourly rate:

Who is the contact to confirm temp?

Any pertinent information or special instructions? 

Email a placement coordinator.