Plume - Transgender Healthcare Provider (Remote)

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Resume/CV ✱
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Full name✱
Email✱
Phone ✱
Current location
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Current company

Links

LinkedIn URL

Clinician Questionnaire

What are your pronouns?✱
Why are you interested in working for Plume?✱
What is your title?
- MD
- DO
- NP
- PA
Do you have prior experience providing Gender Affirming Hormone Therapy to the transgender community?✱
- Yes
- No
Do you have prior experience providing Clinical Services via Telehealth?✱
- Yes
- No
Do you have prior experience providing Adult Primary Care?✱
- Yes
- No
Do you have experience treating Behavioral Health Conditions such as Depression & Anxiety?✱
- Yes
- No
Can you provide at least 10 hours of synchronous time per week?✱
- Yes
- No
Do you have at least 1 DEA license?✱
- Yes
- No
In which state(s) do you have an active DEA?✱
Do you have a Controlled Substance License?✱
- Yes
- No
In which state(s) do you have a Controlled Substance License?✱
In which state(s) do you have an active license?✱
- Alabama
- Alaska
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
- Washington DC
Do you have any pending state licenses?

Additional information

Demographic Survey

What is your location?

Demographic Survey for Plume

For purposes of our EEO and other survey data, we want to make sure we're representing the broad spectrum of sexualities and identities that humanity encompasses. All of the data you provide is anonymous and not attached to your candidate profile. We invite you to complete this optional survey to help us evaluate our diversity and inclusion efforts. Submission of the information on this form is strictly voluntary and refusal to provide it will not subject you to any adverse treatment or affect your job application. This information will be kept secure and confidential and will be used solely to evaluate our diversity and inclusion efforts.

What is your age range?
- 17 or younger
- 18-20
- 21-29
- 30-39
- 40-49
- 50-59
- 60 or older
I identify my ethnicity as
Select all that apply
- White / Caucasian
- Hispanic, Latino, or Spanish origin
- Black or African American
- Asian
- Native Hawaiian or other Pacific Islander
- Indigenous Peoples, First Nations, Native American, or Alaska Native
- Middle Eastern or North African
- Some other race, ethnicity, or origin
What gender(s) do you identify as?
Select all that apply
- Non-binary
- Transgender
- Transmasculine
- Transfeminine
- Genderqueer
- Genderfluid
- Genderfluidflux
- Two-Spirit
- Bi-gender
- Tri-gender
- Quad-gender
- Agender
- A different gender
- Cisgender Male
- Cisgender Female
- Transgender Male
- Transgender Female
- Prefer not to disclose
What is your sexual orientation?
- Asexual
- Bisexual
- Gay
- Straight (heterosexual)
- Lesbian
- Pansexual
- Queer
- Questioning or Unsure
- Same-Gender Loving
- An identity not listed
- Prefer not to disclose