Job Application Form


Please fill out the below information to apply for any of our positions listed on the Careers page.

All fields are required unless otherwise noted.


First Name

Last Name

Your Email

Your Phone Number (numbers only)

What job are you applying for?

What do you think you can contribute most to Willamette Urology?

Why do you want to work for Willamette Urology?

If you are currently working, why are you making the transition to finding new employment?
If you are NOT currently working, why are you no longer with your past employer? Put "N/A" if not applicable.

On a scale of 1 to 5, how comfortable are you dealing with patients, either on the phone or in person?
("1" is the least comfortable, and "5" is most comfortable)
1     2     3    4      5 

Please attach your resume below (optional):