TransTech Medical Solutions

TRANSTECH MEDICAL SOLUTIONS APPLICANT INFORMATION FORM

PERSONAL DATA
First Name:
Last Name:
Middle Initial:
Street Address:
City:
State:
Zip:
Home Telephone:
Cell/Pager:
Email Address:
Is DSL or cable modem available where you live?	Yes No
Do you have a computer?	Yes No	If so, what operating system?

TRANSCRIPTION POSITION DESIRED
Full or part time:	Part Full
Preferred schedule:
Favorite work types:
Favorite specialties:
Date available to start work:

EXPERIENCE
Number of years of transcription experience:
Number of years of clinic work experience		Hospital experience:
Normal production in lines or minutes:		ESL experience:
Software program experience:
Description of transcription experience (with dates), or paste resume: