Caregiver
Personal Information
Format:
(111) 123-4567
Note:
We may call or text you about this job.
(Message & Data rates may apply)
Questions
Do you live in Lake County, Illinois?
Yes
No
Are you available to work in Lake County, Illinois?
Yes
No
What is your hands-on experience in caregiving?
Worked for a facility or agency
Private caregiving
Family & friends only
No Experience (We can still talk)
We hire people without experience. Are you a CNA or a student to become one?
Yes
No
What shifts are you most interested in working?
Open to any Shifts
Day Shifts
Night Shifts
Overnight Shifts
Can you work some weekends?
Yes
No
Please tell me your Availability to work for us:
Are you currently working?
Yes
No
Have you received the Covid-19 Vaccination? (Some of our clients request this)
Yes (Fully)
Yes (Partially)
No (but willing)
Not willing
Do you have a valid Driver’s License?
Yes
No
Do you have Auto Insurance?
Yes
No (but I can get)
No
Do you have reliable transportation that is available to you any time of the day?
Yes
No
Are you at least 18 years of age?
Yes
No
Do you have the legal right to work in the United States?
Yes
No
Did anyone refer you to this job? (We love to give referral bonuses)
Yes
No
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