Client Intake Form

Let's Scope Your First Hire

Complete this form so our team can prepare the right candidates before your discovery call. Takes about 5 minutes.

Prefer to talk? Call or text us: +1 (747) 330-1466

1
Your Business
2
Staffing Needs
3
Timeline
4
Final Details

About Your Business

Help us understand who you are and what your business looks like today.

1–5 employees
6–20 employees
21–50 employees
51–200 employees
200+ employees

Staffing Needs

Tell us which roles you're looking to fill and how many positions you need covered.

Select all that apply.

Medical Virtual Assistant
Medical Biller / Coder
Insurance Verifier
Patient Scheduler
Prior Auth Specialist
Credentialing Coordinator
Appointment Setter / SDR
Executive Assistant
Customer Support Rep
Social Media Manager
Bookkeeper / Accountant
Other / Not Listed

The more detail you provide, the better we can match candidates to your needs.

List any EHR, CRM, or practice management software the hire will need to know.

Current Challenges

What's driving the need to hire? This helps us tailor the candidate brief.

Select all that apply.

Administrative overload
Staff shortages / burnout
High staffing costs
Insurance verification delays
Slow credentialing / revenue
Missed calls / poor comms
Difficulty scaling
Recruiting takes too long

Timeline & Budget

We place most clients within 7–10 days. Let us know your urgency and budget expectations.

ASAP
Within 2 weeks
1 Month
~30 days out
1–3 Months
Planning ahead
Exploring
No hard deadline

Our placements typically run 40–70% less than equivalent US hires.

Final Details

A few last things so we can hit the ground running on your discovery call.

We've Got Your Details

Our team will review your intake form and reach out within 1 business day to confirm your discovery call. We'll come prepared.

7–10 Day placement guarantee
HIPAA-aware virtual staff
60-Day replacement guarantee
English-fluent, pre-vetted candidates