Locum Coverage Request Locum Coverage Request Need a vacation? We will try our best to find a locum for you! Please share your contact information and dates of required coverage below. OK Question Title * 1. Please share your contact information below: Name Clinic City/Town Email Address Phone Number OK Question Title * 2. Please share the dates when you require coverage? OK Question Title * 3. Are you able to provide accommodation and or a vehicle, or other perks? Please describe: OK Question Title * 4. Please provide specifics on coverage needed (i.e. Hospital, ER, extended care, etc). OK Question Title * 5. What type of EMR is in place in your practice? OK Question Title * 6. Thank you for your request. Please enter any additional information you wish to share here: OK DONE