CDI
APPLICATION
Here are the forms that make up our application. You will need to fill out 2 Character Reference forms. They must
be filled out by an RN  it doesn't have to be a supervisor. The Physician's Statement can be filled out by a
Physician's Assistant or a Nurse Practitioner or  MD, and does not have to be a physical done for this application.  
You may elect to apply as self employed if so please read the self employment info.  
If you would be so kind as to send, or bring with you a copy of any references you might have, copies of your FL
lisc. American Heart CPR card, Varicella and MMR records, Heptavax  records, up to date TB test, as well as a
copy of your CEU confirmation for: Domestic Violence, Universal precaution/ HIV, Medical Errors and  End of Life
Care.



Michele Cleary, RN, DON
Critical  Difference , Inc.
cdichell@cs.com
Fax 850-434-1515

Click the files below and open, then simply print and fill out
General Info
Physical
Drug Policy
US Imigration Form
RN Pay Scale
Skills Checklist
LPN Pay Scale
CNA Pay Scale
Reference
Reference
Employee Agreement
Welcome info
Drug free workplace receipt
AHCA form
What is CDI
What the state requires