Welcome :: Sturbridge :: Doctor Online Interview Form

Hello and thanks for being here! My name is Steve and my job is to take care of the business side of our office so that doctors can concentrate on patient care. Your information will be sent to me for review and further processing. Please understand we get many applications and some people are more qualified for the job than others. If necessary, I will contact you for an in-person interview. THANK YOU!

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Online Interview Form * indicates a required field

Position You Are Applying For:

*Full Name:

*Date:

*Address:

*City:

*State:

*Zip:

*Phone (day):

Phone (Other):

*E-MAIL ADDRESS:

Sex:

Marital Status (optional):

Date of Birth (optional):

Age (optional):

Spouse's Name (optional):

Children's ages (optional):

About You

Chiropractic College:

Graduation Date:

National Boards Taken:

1 2 3 4 PT

National Boards Passed:

1 2 3 4 PT

Have You Taken The Alabama Jurisprudence Test?

Are you Licensed in Alabama?

Have You Had Any Issues With A State Board or Regulatory Agency That We Should Know About?

Tell Me About Yourself:

Experience Since School:

What Are You Doing Now?

What Is Your Basic Chiropractic Philosophy?

Why Are You Thinking of Joining Our Group

When would you be ready to start? (House to Sell / Lease Issues, Etc)

What Attributes Can You Contribute To Our Office?

Practice Questions

How Do You Feel About Instrumentation Such as Activator, Pulstar or the ProAdjuster?

How Do You Feel About Physical Therapy Modalities?

Is There Anything In The Office That You Don't Like To Do?

How Do You Feel About Scripting (Memorization Of Certain Sentences or Procedures)?

What Treatment Schedule Would You Prescribe For An Acute Patient?

What Treatment Schedule Would You Prescribe For A Chronic Patient?

How Would You Determine if A Patient Needed Rehab?

How Much Experience In Rehabilitation Do You Have?

And Finally..

How Did You Hear About Our Opportunity? Please Be Specific.

Anything Else You Want To Add?

Click The Browse Button To Attach a Resume or Photograph (Optional)

Confirmation code:

Enter the eight numbers that appear in the image

This form will be emailed to our clinic when you press submit. I understand that internet email is not secure or encrypted.

	We focus on the patient and the patient's condition.
	Our doctors work as a team to alleviate your pain.

NEW Non-Surgical treatment for Pain caused by Herniated and Degenerative Discs.

Congratulations Dr Hart! The readers of the Montgomery Advertiser have voted our very own Dr Jason Hart THE NUMBER ONE DOCTOR in Montgomery.

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© 2006 Copyright Sturbridge Chiropractic

J Hart, D.C. | D Havel, D.C. | L Lemon, D.C. | T Woody, D.C. | H Kwasman, D.C | K Ogletree, D.C. | R Watson, D.C.