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Travel Agreement Submission Form

• Submitting this form will send the clinician's completed travel agreement to the following teams: SNS President, Payroll, Account Management, and Compliance.
• You will receive a confirmation email upon submission.
• If this is a New Placement, it will automatically be added to the Travel Pipeline, alerting the Compliance team to initiate the compliance process.

Assignment Type

Clinician Name

Clinician Specialty

Clinician Status

Hospital

Start Date

Completed Travel Agreement / Rider

Recruiter

Additional Notes