Thank you for your interest in working for our agency.

Please submit the application below to be considered for a position as a caregiver.

Applicant Information:
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Match Criteria:
Indicate caregiver's skills and limitations. These will be used for matching the caregiver with clients.

General

Transfers

Pets

Education & Training:
Employment History:
Please provide your most recent positions of employment.

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Professional References:
Please provide professional references.

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Disclaimer:
I attest that the information in this application is true, accurate, and complete, to the best of my ability. The Agency may verify this information. If I am hired and then it is found that the information is untrue, inaccurate, and/or incomplete, I understand and agree that the Agency is relieved of all commitments, financial or otherwise, pertinent to my employment, and that I am subject to immediate termination without recourse. I attest that I understand if I am an unlicensed person who has direct patient contact, the Agency will conduct a criminal history check, and background checks of the Nurse Aide Registry (NAR) and the Employee Misconduct Registry (EMR) before I am hired. The NAR and EMR checks will be done annually if I am hired. If I have been convicted of a crime that bars employment, I will not be hired. If, at any time, I have offenses listed on the NAR and/or the EMR, I will not be hired. I attest that I understand the Agency will conduct checks of the state and federal Office of Inspector Generals’ List of Excluded Individuals and Entities before I am hired and monthly. I attest that I understand if I am hired, the Agency will submit the Texas Employer New Hire Reporting Form to the Texas Attorney General’s office. I attest that I understand this Employment Application does not constitute a contract. I attest that I understand and agree that if I am offered employment by the Agency, my employment will be “at-will” for no definite period of time and that either I, or the Agency, will have the right to terminate the employment relationship at any time, with or without cause, and with or without notice. I also understand that this status can only be changed by a written contract of employment that is specific as to all material terms and is signed by me and the Administrator, or designee, of the Agency. I authorize any prior employers to provide information requested concerning my employment with them. I authorize the Registrar/Placement Office of all educational institutions I attended to release an official copy of my transcript and, if available, faculty appraisals. I authorize any licensing board to release full information about my license status and license history, if applicable.
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