Agency Name *Recruiter *Recruiter Email Address *Physician Name *Physician Degree *Specialty *Physician Email *Physician Cell Phone *Available Date *Basic Practice History *Motivation for Change *Stage of Interview Process *Timeline for Decision *Most Important Factors of Opportunity *Salary Expectation *Relevant Personal Information *Licenses, Certifications, Background *Medical Malpractice or NPBD Issues *Have you spoken to the candidate? *Last Communication Date *Why is the candidate interested in BVHS? *Most important driver for decision? (i.e.: geographic location, organizational culture, community, compensation, scheduling flexibility, call frequency, mentorship, growth and/or leadership opportunity, etc.) *