South Carolina Collaborating / Supervising Physician MD / DO - Telemedicine Primary Care

Columbia, South Carolina
Telemedicine /
Contract /
Remote

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Collaborating Physician Questionnaire

  • Select all the states you are ACTIVELY licensed in:✱
  • Select all the states you have active DEA(s) with Schedule II in✱
  • List any additional states you are currently licensed to practice in (or N/A):✱
  • Do you have a minimum of two valid DEAs with all schedules (including schedule 2N)?✱
  • Which state do you permanently reside in?✱
  • How many years experience do you have working within a primary care setting?✱
  • We have very high demand and are eager to get great candidates started swiftly. How soon would you be available to start onboarding and collaborating with a cohort of midlevels?✱
  • Our EMR systems requires a computer that is either Mac (MacBook or iMac), or PC with Windows 10 PRO, or Windows 11. What type of computer do you plan on using to access our systems??✱
  • Which Circle Medical team member referred you to this opportunity (first and last name)?✱
  • Briefly describe what has drawn you to apply for this role?:✱

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