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Adirondack Staffing Solutions

Existing Client Update Form

Please fill out the form below to keep us and our candidates informed of your office practices, details, and preferences. 

We like to keep our records updated and candidates informed.

Thank you for taking the time. We look forward to continue serving you.

Client Update Form: Welcome
Image by Michael Browning

Dental Office Information & Agreement

By clicking "Sign Now", Client, “Dental Office” AGREES AS FOLLOWS:

The Dental Office has arranged for temporary, permanent and/or contract placement through Adirondack Staffing Solutions, LLC (the “Agency”). In the event that the Dental Office wishes to offer any additional temporary, permanent or contract placement to any person referred to it by the Agency (“Dental Candidate” or “Associate Dentist”) within one year from the initial date of referral of such Dental Candidate or Associate Dentist, the Dental Office agrees to do so only through the Agency and to pay directly to the Agency the applicable regular fees for any and all such services provided by said Dental Candidate or Associate Dentist. The Dental Office hereby agrees not to directly hire a Dental Candidate or Associate Dentist that has been placed in the Dental Office by the Agency for a period of one year after the placement.  In the event that your Dental Office violates this term, Dental Office agrees to pay to the Agency immediately, to compensate the Agency for lost income and reimbursement for hiring, employment, and marketing a sum of $2290.00 with regard to a “Non-Dentist Candidate”. (Formula: $1600.00 dollars Placement fee, Damages of $600.00 -5% Yearly Advertising costs, $90 labor cost -$30 per hour x 3 hours). And the sum of $6490.00 with regard to a Dentist Candidate. (Formula: $5800.00 dollars Placement fee, Damages of $600.00 -5% Yearly Advertising costs, $90 labor cost -$30 per hour x 3 hours).

  To the extent permitted by law, CLIENT will defend, indemnify, and hold STAFFING FIRM and its parent, subsidiaries, directors, officers, agents, representatives, and employees harmless from all claims, losses, and liabilities (including reasonable attorneys’ fees) to the extent caused by CLIENT’s breach of this Agreement; its failure to discharge its duties and responsibilities set forth in paragraph 2; or the negligence, gross negligence, or willful misconduct of CLIENT or CLIENT’s officers, employees, or authorized agents in the discharge of those duties and responsibilities.

If given less than 48 hours cancellation of placement request or in the event candidate early dismissal; Dental Office agrees to pay a four (4) hour minimum hourly rate to such Temporary Candidate and the Agency.

The Agency’s current regular fees are indicated on the "Placement Fee's" (Exhibit A) document provided above as well as the "Placement Fees RDH PT" (Exhibit B); which fees are subject to change at any time without notice. In the event of frequent cancellations, you may be asked to sign the Frequent Cancellation Agreement, (Exhibit C).

Adirondack Staffing Solutions makes no guarantee on any candidate referred to client on either temporary or permanent basis. 

By signing this Dental Office Agreement, the undersigned agrees to Exhibit A, Exhibit B and the foregoing and warrants and represents that he/she is authorized to sign such Agreement on behalf of Dental Office and to so legally bind said Dental Office.

Accepted and agreed to:

Can you accommodate a left handed hygienist?
How will temporary candidate be compensated?

Thanks for submitting!

Client Update Form: Job Application
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