Verification of Employment Request Form

Epic Staffing Group (ESG) is a diversified national provider of staffing services to the healthcare and bio-pharmaceutical industries. Staffing services include travel nursing, travel allied, contract, international and permanent placement. Epic Staffing Group was formed through the combination of Epic Travel Staffing (formerly EHS), Epic Government (formerly FSR), Epic International Staffing (formerly GHP/VHR), Epic Life Sciences (formerly PLR and OC), Epic Special Education Staffing (formerly Therapy Travelers), and Epic Specialty Staffing (formerly PDC/MSI).

To obtain Employment Verification (EV) from any of the aforementioned Epic Staffing Group companies, please complete the form below. Our turnaround time (TAT) is within 24-48 hours upon receiving your request. For any questions please call (424) 290-1019 / (424) 502-3440 or e-mail EV@EpicStaffingGroup.com.

**If you are an employee needing a Certificate of Employment (COE), please skip this part and e-mail your request directly to HR Admin. at EV@EpicStaffingGroup.com.

Date Submitted: * +

Requested by: (your name) *

Company you represent: *

Name of Employee: (being verified) *

Type of Request *

Please be advised that there will be a $30.00 processing fee for each request and our turnaround time (TAT) is between 24-48 hours upon receiving your request/payment.

Please be advised that this type of request cater to claims and bank-related items only. Should you wish to verify dates for employment, please submit it under Employment Verification.

Delivery Method: *

Fax

E-mail

Email Address: *

Fax Number: *

Cost: *

Verification of Employment: $30

Please upload the authorization from the employee to request a Verification of Employment and any other relevant documents pertaining to your request here. *