If you want to take charge of your medical career, earn more money, set your own schedule and enjoy freedom from the restrictions of the managed care system, we want to hear from you. Fill out the questionnaire below, and we will contact you to see if you have what it takes to become an AM PM physician.
Select Reference:
Home phone:
Work phone:
First Name:
Last name:
Title:
E-mail:
Phone:
Fax:
Mobile Phone:
Adress:
City:
State/Province:
Zip:
Country:
Lead source:
Date of Birth:
Degree:
Medical School:
Board Certified:
Medical Speciality:
Medical License:
License Exp Date:
Resident Program:
Have you ever performed housecalls?
Yes       No
Have you ever been trained in housecalls?
Yes       No
Have you ever been certified in housecall medicine?
Yes       No
Would you be interested in learning housecall medicine?
Yes       No
* Complete the AM PM on-line application
* Interview with an AM~PM Director
* Sign a confidentiality agreement
* Pass the criminal background check
* Pass the credit check
* License verification
* Acceptance of signed contract
Name:
E-mail:
Phone:
We value your privacy and won't
sell your email to third parties