Please fill out the entire form to completion for consideration of staffing by Florence Nursing Services of Rocky Mount. After clicking the submit button at the bottom you will receive a confirmation email with the information you provide.

Please make sure you have the ability to upload the following items before you begin

State issued Identification
Social Security Card
Latest TB Testing Results
Any relevant certifications

File formats required are standard image files: .png, jpeg, .pdf, etc.

Please note that we are not affiliated with Florence Nursing Services located in South Carolina.

- - - Please fill out ALL fields before clicking Submit - Progress will not be saved if you click off this page - - -