Complete the form below,
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School and year of DVM degree
what state(s) are you licensed?
What are your areas of special interest in the practice of
Are you a member of your:
What, if any, are your geographic constraints?
What is your desired annual compensation? $
current annual compensation? $
What was your personal production last calendar year? $
this year-to-date? $
Are payments current on all of your
state and federal income taxes?
What type of Practice do you prefer? (choose
Small Animal & Equine
What size Practice do you prefer? (choose one)
Where do you prefer to practice? (choose one)
In 35 words or less, what are your personal philosophy and
goals regarding your practice of veterinary medicine?
Please provide the name, address and contact
information of a licensed veterinarian that may be contacted
as a personal and professional reference:
How proficient are you in (choose one)
Small Animal Non-Surgical Procedures?
Small Animal Surgical Procedures?
Small Animal Orthopedics?
Large Animal Procedures?
How familiar are you with (choose one)
Is there anything else that you would like for an EMPLOYER
DVM to know about you?
By your electronic signature below, you agree as follows:
1. All information provided to me by DVM RECRUITERS® about
the identity, location, operations, finances and other
details of prospective Employer-DVMs shall be held strictly
confidential, except as may be shared with my agents,
representatives, and legal, financial or other advisors
hired by me for assistance in evaluating said prospective
Employer-DVMs. I agree not to disclose any such information
to any other parties.
2. I assure compliance by my spouse (if any), agents,
representatives, and legal, financial or other advisors with
the requirements of this agreement.
3. I will not circumvent this agreement by entering directly
into any oral or written offer, agreement or employment with
any prospective Employer-DVM introduced to me or whose
identity has been made known to me by DVM RECRUITERS®,
without the specific knowledge and consent of DVM
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