www.greenstaffmedical.com
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78.136.12.127
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Submitted URL: https://updates-icg-medical.com/420X-1HF4X-5XKWX9-ZUA2Q-1/c.aspx
Effective URL: https://www.greenstaffmedical.com/info/contact.asp?dm_i=420X,1HF4X,5XKWX9,5GHE0,1
Submission: On January 17 via api from US — Scanned from DE
Effective URL: https://www.greenstaffmedical.com/info/contact.asp?dm_i=420X,1HF4X,5XKWX9,5GHE0,1
Submission: On January 17 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: details — POST https://www.greenstaffmedical.com/scripts/sendAttachment.asp
<form novalidate="novalidate" style="float: left; width: 100%; margin-top: 20px; clear: both;" action="https://www.greenstaffmedical.com/scripts/sendAttachment.asp" name="details" id="details" method="post" enctype="multipart/form-data"
class="form-horizontal">
<input type="hidden" name="p_recipient" value="centralresourceTeam@greenstaffmedical.com">
<input type="hidden" name="p_subject" value="Greenstaff USA enquiry">
<input type="hidden" name="p_redirect" value="../candidate/emailSuccess.asp">
<input type="hidden" name="p_timestamp" id="p_timestamp" value="17/01/2023 15:26:15">
<style type="text/css">
.p_textinput_hp {
display: none !important;
}
.p_textarea_hp {
display: none !important;
}
.p_textinput_hp1 {
left: -1890px !important;
position: absolute !important;
}
.p_textinput_hp2 {
margin-left: -1890px;
}
.p_textinput_hp3 {
border: 0 none;
height: 0;
margin: 0;
overflow: hidden;
padding: 0;
width: 0;
}
.p_textinput_hp4 {
opacity: 0;
filter: alpha(opacity="0");
}
</style>
<input type="text" autocomplete="off" class="p_textinput_hp" name="p_referrer" value="">
<!-- Div Tab start -->
<div class="tabHeaderDiv openSans standardBox forms" style="width:100%;">
<div class="tab_headContainer" style="width:100%;" alt="" title="">
</div>
<div class="tab_midContainer">
<div class="midInner">
<!-- Title -->
<div class="form-group">
<div class="col-md-12">
<div class="input-group Title">
<span class="input-group-addon">Title*:</span>
<select class="form-control" name="Title" id="Title" required="" data-msg="Please select your Title">
<option value="">Please Select...</option>
<option value="Mr">Mr</option>
<option value="Mrs">Mrs</option>
<option value="Miss">Miss</option>
<option value="Ms">Ms</option>
<option value="Dr">Dr</option>
<option value="Prof.">Prof.</option>
<option value="Other">Other</option>
</select>
</div>
</div>
</div>
<!-- Name -->
<div class="form-group">
<div class="col-md-12">
<div class="input-group name">
<span class="input-group-addon">Name*:</span>
<input type="text" required="" data-msg="Please select a value for Name" maxlength="" name="name" id="name" class="form-control">
<span class="glyphicon form-control-feedback" aria-hidden="true"></span>
</div>
</div>
</div>
<!-- Telephone -->
<div class="form-group">
<div class="col-md-12">
<div class="input-group telephone">
<span class="input-group-addon">Telephone*:</span>
<input type="text" required="" data-msg="Please select a value for Telephone" maxlength="" name="telephone" id="telephone" class="form-control">
<span class="glyphicon form-control-feedback" aria-hidden="true"></span>
</div>
</div>
</div>
<!-- Email -->
<div class="form-group">
<div class="col-md-12">
<div class="input-group p_fromEmail">
<span class="input-group-addon">Email*:</span>
<input type="text" required="" data-msg="Please select a value for Email" maxlength="" name="p_fromEmail" id="p_fromEmail" class="form-control">
<span class="glyphicon form-control-feedback" aria-hidden="true"></span>
</div>
</div>
</div>
<!-- Telephone -->
<div class="form-group">
<div class="col-md-12">
<div class="input-group company">
<span class="input-group-addon">Company*:</span>
<input type="text" data-msg="Please select a value for Company" maxlength="" name="company" id="company" class="form-control">
<span class="glyphicon form-control-feedback" aria-hidden="true"></span>
</div>
</div>
</div>
<!-- Attach File -->
<div class="form-group">
<div class="col-md-12">
<div class="input-group p_attachment">
<span class="input-group-addon">Attach File</span>
<input type="file" name="p_attachment" id="p_attachment" class="form-control">
<span class="glyphicon form-control-feedback" aria-hidden="true"></span>
</div>
</div>
<div class="col-md-12">
<small>.DOC, .DOCX or PDF files</small>
</div>
</div>
<!-- comments -->
<div class="form-group">
<div class="col-md-12">
<div class="input-group comments">
<span class="input-group-addon">Comments:</span>
<textarea required="" cols="" rows="4" data-msg="Please select a value for Comments" name="comments" id="comments" class="form-control"></textarea>
<span class="glyphicon form-control-feedback" aria-hidden="true"></span>
</div>
</div>
</div>
<div class="form-group termsForm emailAttach4">
<div class="col-md-12 col-xs-12">
<div class="input-group Name">
<span class="input-group-addon col-md-5 col-sm-12 col-xs-12" style="width: 40% !important;">Data Protection Notice: <br><small>I confirm I have read the above privacy notice statement and agree to its terms.*</small></span>
<div class="btn-group btn-group-justified col-md-7 col-sm-12 col-xs-12" data-toggle="buttons" style="border: 0px !important; width: 60% !important; padding-right: 0px; padding-top: 8px;">
<label for="p_terms" class="switcherLabels btn btn-select" style="border: 1px solid #CCC !important;">
<input type="radio" name="p_terms" id="p_terms" value="on">Agree </label>
<label for="p_terms" class="switcherLabels btn btn-select active" style="border: 1px solid #CCC !important;">
<input type="radio" name="p_terms" id="p_terms" value="off" checked="">Disagree </label>
</div>
</div>
</div>
<div class="col-md-12 col-xs-12 col-sm-12">
<p><small></small></p>
<p><small>*Greenstaff Medical is committed to protecting and respecting your privacy, and we’ll only use your personal information to administer your account and to provide the products and services you requested from us. You can
unsubscribe from any communications at any time. For more information on how to unsubscribe, our privacy practices, and how we are committed to protecting and respecting your privacy, please review our
<strong><a href="https://www.greenstaffmedical.com/privacy-policy">Privacy Policy</a></strong>.</small></p><small>
</small>
<p></p>
</div>
</div>
<div class="form-group">
<div class="col-md-12">
<a href="javascript:verify();" class="btn btn-success pull-right">Submit</a>
</div>
</div>
</div>
</div>
</div>
<!-- tab end -->
</form>Text Content
This website uses cookies to ensure you get the best experience on our website. Learn more Got it! USA UK Canada Australia China Register Login * Applicants * Jobs * Benefits & Perks * Register * Request a Callback * GS Workforce * Hot Jobs! * Login * Request a Callback * Workforce Resources * Staffing Solutions * Submit a staffing request * About us * Be part of the Voice of Nursing * Referral Program * Contact * Applicants * Jobs * Benefits & Perks * Register * Request a Callback * GS Workforce * Hot Jobs! * Login * Request a Callback * Workforce Resources * Staffing Solutions * Submit a staffing request * About us * Be part of the Voice of Nursing * Referral Program * Contact * Login * Register your cv CONTACT US Address Head Office: 6900 Dallas Parkway Suite 300 Plano, Texas Phoenix: 3101 Central Plaza | 3101-3111 N Central Avenue | Phoenix | Arizona Call: +1-866-672-8432 US International Nursing Tel: +1-833-612-1963 Email: usa.team@greenstaffmedical.com Our social pages: MEET THE MANAGEMENT TEAM × Michelle Campbell RN BSN +1 469 949 8462 Michelle.Campbell@greenstaffmedical.com Michelle Campbell RN BSN Vice President, Business Development & Clinical Services × Charmaine Israel +14699499233 Charmaine.Israel@greenstaffmedical.com Charmaine Israel VP of Business Development × Jon Gaffer +14692509286 jon.gaffer@greenstaffmedical.com Jon Gaffer Director of Business Development × Vijay Ram +1 469 501 2346 vijay.ram@greenstaffmedical.com Vijay Ram Senior Manager - Travel × Brooke Conley +14692500354 Brooke.Conley@greenstaffmedical.com Brooke Conley Account Management × Andria Boyden +1 469 250 0225 andria.boyden@greenstaffmedical.com Andria Boyden Senior Sales Manager × Krishna Singh +1 866 672 8432 Krishna.Singh@greenstaffmedical.com Krishna Singh Sales Manager × Kim Strubel +1 469 444 8078 Kim.Strubel@greenstaffmedical.com Kim Strubel Housing, Travel and Benefits Specialist × Todd Barnes +1 469 998 3139 Todd.Barnes@greenstaffmedical.com Todd Barnes Branch Manager - Per Diem × × × Title*: Please Select... Mr Mrs Miss Ms Dr Prof. Other Name*: Telephone*: Email*: Company*: Attach File .DOC, .DOCX or PDF files Comments: Data Protection Notice: I confirm I have read the above privacy notice statement and agree to its terms.* Agree Disagree *Greenstaff Medical is committed to protecting and respecting your privacy, and we’ll only use your personal information to administer your account and to provide the products and services you requested from us. You can unsubscribe from any communications at any time. For more information on how to unsubscribe, our privacy practices, and how we are committed to protecting and respecting your privacy, please review our Privacy Policy. Submit Home * Home * Blog * Privacy Policy * Terms & Conditions * Cookie policy USA UK Canada Australia China © Copyright 2023 Greenstaff USA Share Share Share Email Share