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Pre-Employment Questionnaire

Supportive Healthcare Moment

Come work with us

Start Date
Day
Month
Year
Do you have experience in this line of work? Or, have you taken care of an elderly or disabled friend or loved-one?
Yes
No
Do you have reliable transportation to and from any work assignments?
Yes
No
Are you comfortable working with clients that:
Do you have experience working with clients that require a Hoyer Lift?* Select an option
Yes
No
Are you legally eligible to work in the USA?* Select an option
Yes
No
Are you willing to work weekend assignments?
Yes
No
Are you willing to undergo a full background and drug test? Select an option
Yes
No
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