McGrath Home Care Services LLC. DBA. Visiting Angels Employment Application
Carefully and accurately fill out all fields. When ready, click "Submit" below.
First Name
ex. Nancy
Last Name
ex. Smith
Email Address
ex. name@domain.com
Primary Phone
555-555-5555
Alt. Phone
555-555-5555
Address
suite/Apt# on 2nd line
City, State, Zip
ex. Walla Walla, WA 99216
1. How many years of experience do you have in caring for the elderly?
2. Are you a CNA? (Certified Nursing Assistant)
Yes
No
3. Do you have experience dealing with Demensia and/or Alzheimer's patients?
Yes
No
4. Tell us briefly about your qualifications for caregiving for the elderly. Ex: Personal care such as bathing, homemaking, etc.
5. Please list your work experience here. Include Co.name, ph.#, contact person and specific duties/responsibilities performed.
6. Are you experienced in 24-hour live-in care? If so, how many days per week can you live-in?
7. Please describe your hours of availability for work, be specific. Ex: 9am-5pm Mon thru Fri., overnights, weekends, etc.
8. List any special training or experience you may have regarding homecare that you'd like to add here.
9. What do you like best about caring for the elderly? Is there any aspect you don't like about senior homecare?
10. Would you be available on short notice for emergency fill-ins?
Yes
No
11. Are you able and do you like working 12-hour shifts?
Yes
No
