Logo, Professional Dental Search, Dental Employment Services in Glenmont, NY 
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CALL: (866) 673-7132
Glenmont, NY 12077
 
Timesheet
Professional Dental Search   P.O. Box 607 Glenmont NY 12077 Office 518 512-4444 Fax 518 462-3379
 

Name_________________________________Name of Dental Office___________________________

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Time Out

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Week Ending                                                                      Total Hours                                                                                

Notice of Agreement

It is required that this office be notified prior to the recalling of any additional temporary or permanent placement. If a Professional Dental Search temporary employee is directly solicited for temporary or for permanent placement by an office signing this voucher or anyone through his or her directive, that person agrees to pay Professional Dental Search its regular charges for all services provided by the Professional Dental Search employee. This is effective for one year after the last day worked in said office. Such employment will be conclusive evidence of your acceptance of our schedule of charges, terms conditions and minimums unless a written modification has been signed.

Dentist Signature_________________________________________________________________

*Please retain copy of Notice of agreement copy for future reference