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Get 6901 South Olympia Avenue Tulsa, OK 74132 (Northeast Corner Of Hwy 75 & 71st Street) Phone Fax

Ay 9:00 am - 4:00 pm 918.388.5701 918.388.2734 Website careers tshmail.com NAME: (LAST, FIRST, MIDDLE) E-MAIL ADDRESS MAILING OR STREET ADDRESS/APT #: PRIMARY CONTACT PHONE: CITY: STATE: ARE YOU OVER THE AGE OF 18? YES www.tulsaspinehospital.com ZIP CODE: ARE YOU ELIGIBLE TO WORK IN THE U.S.? NO YES ALTERNATE CONTACT PHONE: HAVE YOU WORKED AT TSSH BEFORE? NO IF PREVIOUSLY EMPLOYED BY TSSH, LIST NAMES USED ON PAST RECORDS YES IF YES, DATES OF EMPLOYMENT NO DO YOU HAVE RELAT.

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