541-920-1012

The World's Leading Mobile Phlebotomy Group

#1 Independent Phlebotomy Network
Exceptional Pay Structure
Set Your Own Schedule
Fast Pay via Direct Deposit
The Only Phlebotomy Group Recommended By CAA, And Hollywood VIP's

Get our User-Friendly app on your mobile Phones

Download Our Updated Provider App

Become an Independent Phlebotomist Today!

About Our Company

Alpha Phlebotomy Group was created with Patients in mind. The Need for Excellent Mobile Specimen Collection Services is Huge and with a growing list of exceptional phlebotomists compiled over 20 years, Alpha Phlebotomy Group has emerged. Alpha Phlebotomy Group is unique in that we have the ability to tailor programs to meet the needs of our clients. We specialize in Concierge Collections and strive to exceed our clients expectations.

Please take a few minutes to Fill Out the information below!

Full Name *

First Name *

Last Name *

Phone *

Email *

Address *

City *

State *

Postal code *

Country *

Date of birth *

Emergency Contact *

Emergency Contact Relation *

Emergency Contact Phone # *

Emergency Contact E-mail *

Certifying Agency *

Certificate Expiration Date *

Upload Certificate(s) *

Upload Certificate(s)

Professional Liability Insurance *

Professional Liability Expiration Date *

Professional Liability Policy *

Professional Liability Policy

Name of Training Program *

School / Training Program Phone *

Do you have at least 1 Year of Hospital or 2 Years out patient lab experience? *

How Long have you been a Phlebotomist? *

Current Employer *

Current Supervisor *

Supervisor Phone *

May we contact your current supervisor? *

How Long with current employer *

Check the equipment that you have: *

Have you ever been convicted of a felony? *

Resume *

Please Upload your current Resume or CV

References *

What languages do you speak? *

How did you hear about our company *

Profile Picture *

Please Upload a current Profile Picture

Picture of your Drivers License *

Picture of your Drivers License

I understand that Alpha Phlebotomy Group, Inc.is an organization that provides quality specimen collection services and requires all of its contracted collectors to have a minimum of 2 Years Clinical or 1 Year Hospital Experience and/or a current national certification. I understand that it is my responsibility to follow all blood borne pathogen and OSHA guidelines and provide proof of continuing education relating to blood borne pathogens within the last 2 years(please attach). Exceptions Apply for UDS Collectors. I understand that I am listed as a contractor and am responsible for my personal health including any exposure related to or incurred while providing services for APG. I understand that I must represent myself in a professional manner and that APG asks that its collectors wear professional medical attire including white lab coat and closed toe shoes, at all times while at the collection site. I also understand that I must wear gloves without holes or tears at all times while providing patient contact according to standard precautions. I understand that as a contractor I am not an employee of APG but I do represent APG as my client and I must follow ALL of these guidelines stated above. I also acknowledge that all of the information I have provided is true and correct. Further I understand that APG may cease to give assignments without previous notice. *

Clear

Get our User-Friendly app on your mobile Phones

The World's Leading Mobile Phlebotomy Group

Get our User-Friendly app on your mobile Phones

Download Our Updated Provider App

Become an Independent Phlebotomist Today!

About Our Company

Please take a few minutes to Fill Out the information below!

Download Our Updated Provider App

Thank you for being a part of Alpha Phlebotomy Group.

541-920-1012