Caregiver Job Application

If you have trouble with this application, request help at jobs@caringcompanion.net.

Name & Address

    

Contact Info

Resume

RENAME your resume file to include your name (e.g, 'your-name.doc'), then attached it here.

License & Training

            

Professional Reference 1

Professional Reference 2

Background Checks

We are required to conduct background checks on criminal records, driving records, social security verification, and other areas. Indicate below if you consent to these checks.

    

Schedule & Transportation

    
    

General

    
    
Previous or Cancel

Hiring

Documents

Upload required documents to complete the application process.

DocumentIssuedExpiration
Intake Notes Add Document
Contract Add Document
Power of Attorney Information Add Document
Physicians' Orders Add Document
LTC Assignment of Benefits to CCHC Add Document
LTC Insurance Policy Info Add Document
LTC CCHC Authorization to Obtain Information Add Document
Notes Add Document
Auto Insurance Add Document
Auto Registration Add Document
Do Not Resuscitate order Add Document
Notes Add Document
MM HHA Service Request Add Document
Phone Interview Notes Add Document
Interview Notes Add Document
References Add Document
Drivers License Add Document
Drivers License Check Add Document
Auto Insurance Add Document
Auto Registration Add Document
Confidentiality Statement Add Document
Background Check Permission Add Document
CORI Report Add Document
Nurse Registry Report Add Document
Direct Deposit Add Document
I9 Add Document
Social Security Trace Add Document
Tax form state (M4) Add Document
Tax form Fed W4 Add Document
OIG Add Document

Additional Documents

Upload any additional documents that may aid in the application process

DocumentIssuedExpiration