Reflections Home Care Inc Interest Survey

Thank you for your interest in joining the care team at Reflections Home Care Inc. We truly value your willingness to help us deliver compassionate, high-quality care to individuals in our community.

As we move forward in the process, we kindly ask that you complete a brief survey. Your responses will help us gain a better understanding of your background, allowing us to explore how your strengths can best support our mission.

We appreciate your time and look forward to learning more about you.

Full Name  *
Email *
Phone number  *
Preferred Method of Contact *
Required
Do you have any prior experience in the healthcare field? *
If you answered yes, please briefly describe your experience. If no, please type n/a.   *
Have you ever worked in home health care before? 
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If you answered yes, please briefly describe your experience. If no, please type n/a.   *
What certifications or licenses do you currently hold? (Check all that apply)
 *
Required
How many years have you been certified? *
What's your availability? Please list the days you are available.  *
Required
Is there a specific time of day that you cannot work?  *
Will you be able to pass a background check and drug test? (IE: No felonies, theft, drug convictions, etc.) *
Do you have a valid drivers license and. reliable transportation? *
Do you have a current TB skin test on file? *
How far are you filling to travel within New Bern and surrounding areas (Vanceboro, Cove City, Fort Barnwell , Dover, Bridgeton)?  *
Are you comfortable with pets in the home *
Do you have a valid CPR card? *
If hired, when are you available to start?  *
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