RRT · CRT Application

Join our respiratory therapy team

Success Nurse Agency Inc staffs Registered and Certified Respiratory Therapists across hospitals, LTACHs, subacute rehab and skilled nursing in Chicago and the surrounding suburbs. Complete the RT-specific application below and upload your NBRC credential, IL RCP license, and life-support cards.

Personal Information

Credential & Experience

Required RT forms — complete and e-sign each one

0/4 completed

Open each packet, answer every question below it, then type your full legal name to sign electronically. Your answers, typed name, date and device details are recorded as your signature (E-SIGN / UETA), and you can print the completed copy after approval.

Complete the acknowledgment below. Your answers are saved with your signature and become part of your personnel file.

Job Description PacketForm not complete

Confirm the job description for your credential and note any accommodation request.

Fill out your employment application. Every field is required before you can sign.

Complete the electronic skills checklist first — your ratings are attached to this signed form.

Current Certifications

Check what you currently hold. We connect with the American Heart Association to keep your BLS, ACLS, PALS and NRP credentials current.

Availability

RT Skills Checklist

Rate your experience with each skill for your RT license. Every item must be rated — this checklist is part of your application and is reviewed with your documents.

0 of 25 rated · 0 proficient0% (min 80%)

Airway & Ventilation

Intubation assist and airway adjuncts
Invasive ventilator setup and management
Non-invasive ventilation (BiPAP / CPAP)
High-flow nasal cannula titration
Trach care, changes, and cuff management
Open/closed suctioning and lavage

Diagnostics & Monitoring

ABG draw, analysis, and interpretation
Capnography / EtCO2 monitoring
Bedside PFTs, spirometry, peak flow
Weaning parameters (NIF, VC, RSBI)
Pulse oximetry & oxygenation assessment

Therapeutics

Aerosol / nebulized medication delivery
MDI with spacer and patient education
Chest physiotherapy, vest, PEP therapy
Incentive spirometry & lung expansion
Oxygen devices — NC, mask, non-rebreather, venturi

Emergency & Critical Care

BLS / CPR — current AHA card
ACLS — current AHA card
PALS / NRP (pediatric & neonatal)
Code / rapid response airway role
Intra-hospital transport of vented patients

Documentation & Safety

Charting in Epic / Cerner / PCC
Protocol-driven therapy & physician orders
PPE, isolation, and circuit infection control
Equipment checks, alarms, and troubleshooting

By signing, I certify these ratings are true and accurate to the best of my knowledge.

Upload Documents

Accepted: PDF, JPG, PNG, HEIC. Max 15MB per file. All uploads are private and encrypted.

By submitting this application I certify that the information and documents provided are true and accurate. I authorize Success Nurse Agency Inc to verify my NBRC credential and IL RCP license, run a background check, and contact the references I've listed.

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