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STEP 1 OF 2

In-Home Caregiver

PRESCREEN QUESTIONS

Are you legally authorized to work in this country? *

Yes

No

Can you pass a required background check?

Yes I will pass a state, federal, and FCSR screenings.

No, I will not pass all of the required screenings.

Are you at least 18 years of age? *

Yes

No

Do you have a VALID driver's license? *

Yes

No

Do you have auto insurance?

Yes

No

Do you have a smart phone and ability to know how to operate standard download mobile apps? *

Yes

No

Do you have a private reliable car to get back and forth to work in? *

Are you looking for Part Time or Full Time work? *

Full Time

Part Time

PRN - Occasionally/Work Around Current Schedule

Let's talk about what we consider related experience for this role:

RELATED EXPERIENCE

✅ Jobs that directly involve caring for seniors or adults with disabilities.
Examples: working as a caregiver, CNA, HHA, in-home aide, nursing home staff, assisted living, hospice, or helping an older family member with daily needs.

NOT RELATED EXPERIENCE

❌ Jobs that do not involve direct caregiving or supporting seniors.

Please describe your experience RELATED to this role? *

Is the RELATED experience within the last year? *

I don't have any.

Yes, currently still doing it.

Yes, it's within the past year.

No, it's more than a year ago.

This type of work can be tiring, are you able to stand, bend, kneel, twist and consistently lift 25 lbs throughout the day to perform the necessary duties in this role? *

Yes

Maybe

No

What is your availability?

Example:

Monday - Friday 8am-8pm
MWF Overnights 7pm-7am
Sunday 2pm-10pm

Do not say "open availability" unless you are truly available 24/7, 7 days a week.

Please list out your full availability: *

STEP 2 OF 2

CONTACT DETAILS

Full Name *

Email *

Phone *

Address *

City *

State *

Postal code *

By submitting this form, you agree to receive email and text alerts from us about the job you're applying for. This includes info about the application process, interview reminders, and job updates.

Additionally, you confirm that all the information provided in this application and during the upcoming interview is entirely true and accurate. You also understand that if anything is found to be false, the company can use at-will employment to end our association.