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About KREWE
- Our Story
- The Team
For Clinicians
- Clinician Services
- Job Board
For Facilities
Referrals
- Refer a Colleague
- Refer a Facility
Contact Us

Client
Opportunity Overview

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1Facility Information and Need

2Contacts (update if necessary)

3Professional Requirements

Client Name: *

Contact Person Name: *

First

Last

Contact Phone Number: *

Contact Email: *

Type of Healthcare Professional Needed: *

CRNA
Anesthesiologist
Other

Specialty or Specialties Needed:

Number of Professionals Needed:

Reason for Need:

Additional information regarding need:

Duration of Need:

Assignment Target Start Date:

Special Requirements or Notes:

Shift Details:

8
10
12
16
24
Night
Weekday Call
Weekend Call

Minimum hours paid when called back in:

Will you accept New Grads?

No
Yes
Tell me about Krewe's New Grad First-Year Flex Program

Worksite Address:

Address Line 1

Address Line 2

City

State

Zip Code

If the providers will work at any other location(s), please list them here:

Save and Resume Later

Please update the following Contacts if they have changed since the last assignment:

Credentialing Contact:

First

Last

Credentialing Contact Phone:

Credentialing Contact Email:

Orientation Contact:

First

Last

Orientation Phone:

Orientation Email:

Billing Contact:

First

Last

Billing Phone:

Billing Email:

Candidate Submission Contact:

First

Last

Candidate Submission Phone:

Candidate Submission Email:

Time Card Approval Contact:

First

Last

Time Card Approval Phone:

Time Card Approval Email:

After-hours Emergency Contact

First

Last

After-hours Phone:

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Is the Provider required to be certified in the following?

BLS
ACLS
ATLS
ABLS
PALS/APLS
NRP
DEA License

Anesthesia Areas and Procedures

Please mark the most applicable choice for each item in this section:

General Anesthesia (Adult)

Required
Preferred
Not Required

General Anesthesia (Pediatric)

Required
Preferred
Not Required

General Anesthesia (Neonatal)

Required
Preferred
Not Required

General Anesthesia (Trauma)

Required
Preferred
Not Required

Spinal Anesthesia

Required
Preferred
Not Required

Epidural Anesthesia

Required
Preferred
Not Required

Regional Anesthesia

Required
Preferred
Not Required

Obstetrical Cases

Required
Preferred
Not Required

Neurosurgical Cases (Head)

Required
Preferred
Not Required

Neurosurgical Cases (Spine)

Required
Preferred
Not Required

Open Heart Anesthesia

Required
Preferred
Not Required

Thoracic Cases (except Open Heart)

Required
Preferred
Not Required

TAVR

Required
Preferred
Not Required

Complex Vascular Cases (except Open Heart)

Required
Preferred
Not Required

Endoscopy

Required
Preferred
Not Required

Cath Lab

Required
Preferred
Not Required

Pain Management Techniques

Required
Preferred
Not Required

Post-Op Epidural

Required
Preferred
Not Required

Post-Op Extremity Blocks

Required
Preferred
Not Required

Use of Ultra-Sound in Placement of Blocks

Required
Preferred
Not Required

Insertion of Central Line

Required
Preferred
Not Required

Insertion of Arterial Line

Required
Preferred
Not Required

Other requirements or comments:

Management of: PA Catheter

Required
Preferred
Not Required

providers will Neurosurgical

Name *

Title *

Signature *

Clear Signature

Date *

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Email *

info@krewesolutions.com

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Krewe Anesthesia

About KREWE
- Our Story
- The Team
For Clinicians
- Clinician Services
- Job Board
For Facilities
Referrals
- Refer a Colleague
- Refer a Facility
Contact Us