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Do you currently, or have you ever had ownership in a private practice? If so, please explain.*

How did you hear about Risas Dental and Braces? (Please list any doctors you may already know)*

How many 3rd molar extractions have you done? How many implants placed?*

How many molar root canals have you finished? How many extractions have you done?*

When would you be available to begin with Risas if offered a position?*

Are you fluent in any other languages other than English?*

Are you authorized to work in the United States?*

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For US Residents Only: EEO Voluntary Self-Disclosure

We are an equal opportunity employer and are subject to certain non-discrimination and affirmative action record keeping and reporting requirements. We request your voluntary cooperation to assist us in meeting out legal obligations and in analyzing the effectiveness of our equal opportunity efforts.

Pleae note the submission of this information is completely voluntary. You will not be subject to discharge, discipline, or any adverse treatment if you elect not to disclose this information. This information will not be used in reaching a hiring decision. Information obtained will be kept confidential and may only be used in accordance with the provisions of applicable federal laws, executive orders, and regulations, including those which require the information to be summarized and reported to the Federal Government for civil right enforcement purposes.

Residents outside the US should select "I choose not to disclose". US Residents please choose any applicable option.

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