Application

APPLICATION FOR EMPLOYMENT

We consider applicants for all positions without regard to race, color, religion, sex, sexual orientation, national origin, age, marital or veteran status, non-job related medical conditions or disabilities, or any other legally protected status.

You can be assured that your information will be kept confidential with our Human Resources representatives and staff. If you feel more comfortable mailing in your application, you can download a copy of it by clicking here.

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RN Shift LPN Shift Infusion RN Assessment RN Trainer/Instructor RN Visit Nurse Home Health Aide Personal Care Aide Physical Therapist Occupational Therapist Training Class PCA Coordinator Receptionist 

 Yes No

 Yes No

 Full Time Part Time Per Diem Days Evenings Weekends

Education

 Yes No

*I understand that an offer of employment is contingent on the completion of the hiring process, including medical screening, license verification, motor vehicle checks, fingerprinting (Aides only), CHBRC checks and references. Employment will be on a 3 month introductory basis and that my employment at Wellness Home Care, Ltd. may be terminated, with or without cause or notice, at any time, at my option or that of the company. I understand that no management representative has any authority to enter into any agreement for continuing employment for any specific period of time or which is contrary to the foregoing.

I give Wellness Home Care permission to contact all or any of my previous employers and references and authorize them to provide all information requested. I authorize them to obtain, use and rely upon that information in relation to my application. I have provided truthful and complete responses to all inquiries in the application and understand that the discovery of any falsification or omission constitutes a ground for immediate dismissal. If employed I will abide by Wellness Home Care's rules and regulations, which I understand are subject to change at any time at the discretion of the agency.

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 By checking this box I agree to the above statement.

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