Comfort Hands Careers – Apply Now – Comfort Hands

Careers - Application

Demographic Information

Tell us about yourself.

First Name

Last Name

Phone/Mobile

Social Security Number

Date of Birth

US Residency Status

US citizen

Noncitizen national

Permanent Resident

Alien with work permit

Current Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Previous Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Position/Availability

What position you are applying for and how available are you?

Position Applied For

License:

What licenses or certifications do you have?

License / Certification No.

Issuing Authority / Board

Expiration Date

Has your Professional license been suspended, revoked or under investigation?

Yes

If yes, Please explain

Additional Certifications:

Select all certifications that apply.

Certifications

PALS

CPR

BCLS

ACLS

PALS EXPIRATION DATE

CPR EXPIRATION DATE

BCLS EXPIRATION DATE

ACLS EXPIRATION DATE

Employment History

What work have you done in the past?

Current / Most Recent Employer

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Job Title

Responsibilities

Still Work Here?

Yes

Start Date

End Date

Supervisor's Name

Supervisor's Phone Number

Reason(s) for Leaving

May we contact your current/previous employers

Yes

Previous Employer

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Job Title

Responsibilities

Personal/Criminal Records

Do you have any personal or criminal Records?

Have you ever been convicted of any crime?

Yes

If yes explain

Education History

Tell us about what schools you've been to

Highest Level of Education

Bachelor's or Higher

Associate's

GED

Other

Graduation Date

School Name

Address

City

State

Zip Code

Malpractice Insurance Provider

Malpractice Insurance Policy #

References

Please list three individuals with whom you have worked with or for who are able to evaluate your performance

Name

Title

Address

Telephone/ Email

Name

Title

Address

Telephone/ Email

Name

Title

Address

Telephone/ Email

Upload Resume

Choose File

Consent and Authorizations

I hereby authorize Comfort Hands Home Health Care LLC to request and receive from all prior employers within one year of the date of this application, any and all pertinent information concerning my prior employment and its termination, including the reason for such termination.

Yes

In connection with my application for employment with Comfort Hands Home Health Care LLC. I authorize the agency or its agents to procure a consumer report and/or investigative consumer report about my background, character or reputation, including, but not limited to, information as to my employment, education, consumer credit history (consumer credit history will only be verified if appropriate for certain job descriptions), driving record, social security number verification, criminal record, and/or other public records history. I authorize all persons to fully disclose information relevant to this investigation. I release from liability all persons, companies, and governmental or other agencies disclosing such information. I further authorize that a photocopy of this authorization may be considered as an original.

Yes

Date

Consent to SMS Messaging

I consent to receive SMS notifications related to my work, including shift reminders, clock-in/clock-out confirmations, and scheduling updates. I may opt out at any time by replying STOP

Yes

I have read and agree to the Terms and Conditions and Privacy Policy

As required by federal and state law, we are an equal opportunity employer and manage our per diem employment and employee relations practices without discrimination based on race, age, color, religion, national origin, medical condition, marital status, sex, citizenship status, ancestry, sexual orientation, creed, disability, or handicap. Our company will comply with all relevant state mandates. I acknowledge that Comfort Hands Home Healthcare is a per diem employer.

Demographic Information

Position/Availability

License:

Additional Certifications:

Employment History

Personal/Criminal Records

Education History

References

Consent and Authorizations

Consent to SMS Messaging

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