Heartland Information Services, Spryance, Inc., Merge    
Combined companies create premier outsourced transcription provider    
   

Application for HMT

(All information will be kept strictly confidential. Candidates may be disqualified at any time of his/her association with the company if any information is found to be wrong or misleading.)

Personal Details
Full Name
Address
City
PIN Code
Landline No. STD Code: No:
Mobile No. STD Code: No:
Email
Post Applied For
Date of Application(dd/mm/yyyy)
Best Time to Contact You at Home
Date of Availability for Work(dd/mm/yyyy)
Availability on Sunday
Willing to Work in Night Shifts
Experience in Medical Transcription
(Details of Previous Employers)
Consecutive Years of Experience in Transcribing
Lines Produced Per Day
Consecutive Years of Experience in Editing
Lines Produced Per Day
Are You Experienced in Handling STAT Jobs?
Have You Worked as Home Based MT/Editor?
If yes, Specify Period Years/Months
Format of Experience
ER Discharges H&P
Operative Consults Radiology
Oncology Non-acute Exp Pathology
Ophthalmology Cardiology/Cardiac Caths
Accent Experience
American British Australian
Hispanic Chinese Indian
Arabian
Equipment & Software
Computer Configuration
Modem
WAV Pedal
Internet Connection
Electricity Backup
Do You Want Microsoft XP Version
Stedman's Medical Spell Checker Version
Personal/Professional References
Name
Phone No.
Best Time to Call
Occupation
Name
Phone No.
Best Time to Call
Occupation
Educational Details
Name Medium Of Instruction Year Of Passing Degree/Certificate
(e.g BSc, BCom, etc)
School
College
University
/Board