Employee Referral

  • This form must be completed before HR receives the candidate's application.
  • Candidate information

  • Any information submitted is NOT ENCRYPTED and may be intercepted by an outside party. Glacial Ridge Health System cannot guarantee that any information submitted through this website will remain confidential. Information submitted is not intended to be directed towards patient care. Thank You.
  • This field is for validation purposes and should be left unchanged.

NEW EMR Dec 1, FOR APPOINTMENTS:
Please Bring Insurance Card and Driver's License/State ID