Name* First Last Date* MM slash DD slash YYYY Why are you interested in working at NCAP and are you familiar with Northern Colorado/ Wyoming?*Describe the types of care models you have worked in during your career/training (e.g. medically directed, medically supervised, solo). What is your preferred care model and your preferred level of independence/supervision in practicing? (NCAP uses a medically-supervised care team model.)*NCAP provides anesthesia services in three geographic areas. Which do you prefer?* NORTH pod: Fort Collins, Loveland, Greeley SOUTH pod: Lafayette WYOMING pod: Laramie There are several CRNA scheduling models, not all of which may be available at any given time. Please indicate all types you may have interest in.* North: W-2 Employee: Full-time with Overnights North: W-2 Employee: Full-time Day Work North: W-2 Employee: .8 FTE Day Work South: W-2 Employee: Full-time with Overnights South: W-2 Employee: .8 FTE, Overnights North and South: 1099 Contractor, various shifts Wyoming: W-2 Employee: Full-time If interested in a 1099 Contractor (PRN), position please let us know your availability for day, evening, overnight, and pager shifts.*Please tell us about the practice characteristics that are the most important for your next career move (e.g. types of cases you prefer, your ideal work environment/culture, preferred hours of work/call per week, etc.).*What are your annual compensation expectations for this position?*What is the earliest date (month/year) you would be available to start working at NCAP? Also, please describe any advance notice requirement you have with your current practice.*For referral purposes, do you know any current NCAP providers?*Please Attach Resume*Max. file size: 300 MB.Additional Documents (references, case logs, etc) Drop files here or Select files Max. file size: 300 MB, Max. files: 10.