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These documents are required to be on file with Independent Nursing Services before placement at any client or facility.
Fax to (586) 771-4205
Mandatory Items
RN & LPN
Home Health Aids and Homemakers
Current Resume
Resume or letters of Recommendation
Current Michigan License
Copy of Drivers License
Neg. TB Test or CXR results with signs and symptoms sheet.
Certificate of Auto Insurance
Current BLS-Healthcare Provider for Facility Placement
Copy of Current Michigan Certificate/ License and any additional certifications or training.
Current ACLS for Critical Care
Copy of Hepatitis B. Vaccine or Vaccine Decline Release Form- HEP B Vac Declination Form
Completed Home Health Aide Skills Checklist and Tests
Proof of Serum Titers: MMR and Vericella Hep C Titers for certain facilities
Neg. TB Test or CXR results with signs and symptoms sheet
Available Payroll Downloads
2008 W4 Tax Form
Federal I9
MI W4
Detroit Tax
Direct Deposit
Click here to continue to Application Form