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CONTACT INFORMATION
Employment Questionnaire
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* Indicates required question
First, Last name
*
Your answer
Phone Number
*
Your answer
Email
*
Your answer
Position(s) of Interest (check all that apply)
*
Home Health Aide (HHA)
Direct Care Worker
Transportation (Driver) *Must have a valid PA Driver's license
Required
Do you have previous job-related experience?
*
*PLEASE NOTE: All employees are required to have a resume on file. If you have a current resume, please send to
caringhandspersonalhomes@gmail.com
. If you are brought in for an interview, and you do not submit a resume beforehand, please bring a resume with you to your interview.
Yes
No
Do you have either a Direct Care Certification or HHA certification?
*
Yes
No
Are you CPR-certified?
*
Yes
No
If applying for a HHA position, do you have either an updated 2-step PPD (within 1 year), Quantiferon (within 1 year), or Chest X-Ray (within 5 years), Covid-19 Vaccination (fully vaccinated)?
*
Yes
No
If you said "yes" to the above question, which one do you have?
*
2-step PPD
Quantiferon
Chest X-Ray
Covid-19 Vaccination
DMV Records (Must be within 3 years) *Driver's Applicants Only
What shift(s) are you able to work?
*
Day time
Evenings
Overnight
Weekends
Required
How did you hear about Caring Hands?
*
Job Posting/Ad
Social Media
Referral
If referred, what is the name of the person who referred you?
*
Your answer
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