A division of Marketing Resources of Burlington, Inc.
Consultant Skills List Form

All information contained in this form is confidential and will not be released to others.

Is certification current?
Worked for ACOS approved hospital?
Worked for a Non-ACOS hospital:
Member of NCRA:
Have you been through a survey?
Have you independently contracted?
Have you worked for a contracting company?
Are you willing to travel?
Are you setup to work from home?
Send a copy of the message to yourself?