RCP/Info Request

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Please fill out the following form and submit.  A representative will contact you shortly.  Should you have any questions, please feel free to contact us at (800) 827-3723 -- (602) 234-0494 and we will be happy to assist you.  Thank you for your time.



Facility Name:


City:   State:   Zip:

Phone:   Fax:


Approximate Date Needed:
Select closest time:

Approx. Length of Assignment  (pick closest):

Tell us about your facility and your needs ....

Clinical Areas for RCP to work in your facility (select all that apply):

     General Floor       ICU        CCU         NICU        Peds 
     ER/Trauma    Open Hearts  Other

Please list the ventilators used in your facility:

Charting Methods Used:
    Written Only    Computerized Only    Combination

     If computerized, please list which:

Do you currently use outsourced supplemental staffing?   Yes    No

I am interested in the following information (check as many as you'd like):

    General Brochure/Information

    Information about IRS's Rates for their various programs


    Customized Proposal for my organization with a Cost/Benefit Analysis

Thank you for your time and interest in Immediate Respiratory Staffer's RCP Staffing Solutions.  Please click on the Submit button below and a representative will contact you shortly.

IRS...the best client/customer service, the best practitioners, the right choice!



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Copyright 2000 Immediate Respiratory Staffers, Inc.
Last modified: June 01, 2004