Caregiver Application

Caregiver Application
Are you over 18 years of age?
Are you legally eligible to work in the United States? *
How flexible are you to cover shifts and substitute for teammates, outside of your regular work schedule?
Our night shifts are awake shifts. If applying for a night shift, do you foresee any difficulty remaining awake and alert for the entire shift?
Do you have reliable transportation?
This position requires working some holidays and may require overtime, weekend work, and staying on shift until your relief arrives. Do you foresee any problems fulfilling these requirements?
Days: 7am – 3pm
Swings: 3pm – 11pm
NOC: 11pm – 7am

Employment History

Are you currently employed?
Can we contact this employer?
Can we contact this employer?
Can we contact this employer?


Skills & Abilities

Are you restricted from lifting specific weights?
Have you dealt with incontinence (both bowel and bladder) and used incontinence products on any of your previous jobs?
This job requires you to transfer residents from bed to wheelchair and from wheelchair to bed or toilet or chair. Do you have any physical limitations that would prohibit you from task?
Is there any phase of housekeeping that you cannot do or are unwilling to do?


Employee Credentials

Check the boxes of your current credentials:
How did you hear about this open position? *