Please read options carefully before selecting your answer.
This agreement dated this day of
executed by and between Southern Medical
Staffing, LLC ("SMS", located at 1500 Metro Dr., Alexandria, Louisiana 71301, and
("Contractor"), whose mailing address is
Whereas, SMS seeks to engage Contractor to accomplish the objectives described in the Exhibit titled "Qualifications and Description of Services to be Performed by a Licensed Practical Nurse", which is attached hereto.
Whereas, based on the nature of the relationship that the parties intend to establish, SMS hereby engages Contractor as an Independent Contractor.
Now, therefore, in consideration of the mutual promises and covenants of the parties as herein contained, the parties hereto agree and contract as follows:
In witness whereof, the parties hereto have executed this Agreement on the day and year first above written.
The Licensed Practical Nurse assists with patient care according to the patient plan of care, observes and records pertinent information and reports to appropriate supervisor.
1 = No Experience
2 = Some experience but require supervision or additional training
3 = Experienced and does not require supervision or additional training
Please select your experience level as it applies to you.