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Candidate Registration: MDC Staffing LLC, Shiftboard

If you have already registered for access to our online scheduling system and you have already received your welcome email message with your temporary password, please sign in using that password. 

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Thank you for your patience, it might take a few hours or days until your registration has been processed.

* required field
APPLICANT INFORMATION
 
ADDITIONAL INFORMATION
I am a:
Front Desk Administrator
Dentist
Registered Dental Assistant
Office Manager
Registered Dental Hygienist
* Educational Level
* Years of Experience
Months of Experience
Experience Start Date
What days are you available?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Have you had any experience in the following specialty fields?
Perio
Endo
Oral Surgery
Pedo
Ortho
Traditional
Invisalign
Prostho
Are you interested in a Permanent Position?
Are you interested in a Temporary Position?
Dental License State
Dental License ID
License Expiration
Please tell us your hourly rate:
Do you take digital x rays?
 Yes  No
DO YOU HAVE CEREC EXPERIENCE?
 Yes  No
DO YOU HAVE ITERO EXPERIENCE?
 Yes  No
Which Dental software are you familiar with?
PPO
 Yes  No
HMO
 Yes  No
MEDICAID/MEDICARE
 Yes  No
OTHER:
Do you wear Loupes with a light?
 Yes  No
Other:
Are you Nitrous Oxide Certified?
 Yes  No
Are you Laser Certified?
 Yes  No
Are you Sealant Certified?
 Yes  No
Are you Coronal Polishing Certified?
 Yes  No
How were you referred to MDC staffing?
Are you Bilingual?
 Yes  No
What Languages?
Level 1 Sedation Permit
 Yes  No
Jurisprudence Assessment for Licensure renewal
 Yes  No
Completion Date
Background Check Information
* Do you consent to a background check?
 Yes  No
* Felony Convictions
 Yes  No
* Drivers Licence Number
* Drivers License State
Social Security Number
Birthdate
If you have your CPR license, what is the expiration date?
Have you had OSHA training?
 Yes  No
Have you had HIPAA training?
 Yes  No
Have you had Hepatitis B Vaccine?
 Yes  No
I have been advised of the benefits of the Hepatitis B Vaccination but I am declining the vaccination at this time. If so, complete date below.
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Cypress, Texas 77429
713-953-9500
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