Forms & Information

As a Signature Healthcare employee a variety of forms will need to be completed before placement occurs. For your convenience, we have made many of these forms accessible to you. Simply download and print the forms listed below. Once completed either fax, mail or bring them to our office.

All the forms listed below are in Adobe Acrobat (pdf) format. Download Adobe Acrobat here for free if you do not already have it on your computer.
Application for Employment
Apply Online
Download PDF Version
 
The following skills checklists are available for download. If you do not see your specialty, please call us at 515.252.0000 or click here to complete online.
 

Skills Checklist:

Our complete library of skills checklists are available to you by simply filling out our online application. You can complete the checklists online and electronically submit them to us! Click on the Apply Online to start your new career! Below you will find our skills checklists that have been made available for download.
Clinic
Critical Care
Emergency Department
LPN
Long Term Care
Medical / Surgical
OB / L&D / NN
Occupational Health Skills Checklist
Operating Room
Post Partum

Applicant Forms:

 
Application for Employment
Download PDF Version
 
Required Document Checklist
Download PDF Version
 
Professional Reference Request Form
Download PDF Version

Insurance Forms:

 
United Healthcare Enrollment Form
Download PDF Version
 
United Healthcare Explanation of Benefit
Download PDF Version

The Joint Commission:

 
2008 National Patient Safety Goals
Visit Their Website
 
Official “Do Not Use” Abbreviation List
Download PDF Version

Medical Forms:

Hepatitis B Form
Latex Allergy Physician Release
Statement Of Health Annual
TB Assessment Form

Payroll Forms:

 
Federal W-4 – 2008
Download PDF Version
 
State W-4 – 2008 (Iowa)
Download PDF Version
 
I-9 Packet
Download PDF Version
 
Timecard Instruction and Payroll Information
Download PDF Version
Once you have completed the forms either fax or mail them to our office:

Signature Healthcare
Attn: Human Resources
3815 NW 109th Street Ste B
Des Moines, IA 50322
Phone: 515.252.0000 or 1.800.518.1460
Fax: 515.276.5506