(888) 684-6064 / 8:30 AM - 5:30 PM Eastern

Thank you for your interest in Health Fitness Concepts RN, LLC (HFC). HFC maintains a large pool of licensed health professionals who perform work as independent contractors. If you are a Registered Nurse, Licensed Massage Therapist, Certified Exercise Instructor and are interested in becoming a part of our pool complete this form and we will be in touch with the next steps.

    A. Identifying Information:

    Last Name
    First Name
    Middle Name

    B. Contact Information - HOME:

    Street Address
    Zip Code
    Home Phone
    Cell Phone / Cell Provider (ATT, Verizon – for texting purposes)
    Fax (if applicable)
    1st E-mail Address
    2nd Email Address

    C. Languages other than English (Spoken and understood fluently):

    D. CURRENT Profession

    E. MEDICAL or other License Information:

    State License No Expiration Date Type of Medical License
    New York
    New Jersey

    F. Additional Training and Certifications:

    Please briefly describe any relevant training and experience (e.g.: specialties, phlebotomy) Training Date

    Work Specific Information:

    Please indicate the type of services below that you have had experience providing or would like the opportunity to be trained:

    Type of Service
    √ Yes, I have done before
    I would welcome the opportunity to be trained or refreshed on these skills
    Blood Pressure
    Body Fat
    Bone Density
    CardioVision (arterial stiffness)
    Cholesterol Testing
    DermaScan (skin damage assessment)
    Flu Shots
    Glucose Testing
    Lung Function
    Preventive Health Counseling
    TB Testing
    Vision Screening

    Massage Therapists:

    • Yes or No
    YesNo Do you have a massage chair?
    YesNo Do you have a massage table?
    YesNo Are you willing to bring your table/chair to events?
    YesNo Do you provide draping for table clients?
    YesNo Is table covered with a sheet?
    YesNo Can you bring relaxing music?


    Check the days and times that you ARE available:

    Monday Tuesday Wednesday Thursday Friday Weekends (rarely have work)


    Anytime Between 9:00 5:00 Other Times (i.e. 10 – 2)
    Time Limitations (write below)


    Westchester Manhattan New Jersey Connecticut Long Island


    Do you drive? Are you willing to car pool? Do you know the subway system? Do you have space at home to store event supplies (flu shots..)
    YesNo YesNo YesNo YesNo

    Health Fitness Concepts RN, LLC is an equal opportunity employer –
    Women and minorities are encouraged to apply.

    It is the policy of Health Fitness Concepts RN, LLC to provide for and promote the equal opportunity of employment, compensation and other terms and conditions of employment without discrimination because of age, race, creed, color, religion, gender, ethnicity, alienage or citizenship status, familial status, genetic predisposition, national origin, disability, marital status, carrier status, sexual orientation, or record of offenses.

    Health Fitness Concepts RN, LLC
    Certified Woman Owned Business
    45 Knollwood Rd. Suite 200, Elmsford, NY 10523
    Phone: 914.684.6064
    Fax: 914.684.6071
    Toll Free: 888.684.6064