Employee New Starter Form

Lotus Home Care - Employee New Starter Form

Please complete the form below to provide us with certain payroll information.
Which branch will you be working for*
Full Name*

First NameLast Name
Current Address*

Street Address

Street Address Line 2

CityCounty

Postcode
Will you be staying at the above address following commencement of your employment with Lotus Home Care?*

YesNo (I will be moving and I will let you know of the new address as soon as I have found a suitable address)No (I will be moving to a new address and I provide these details below)
Proposed Address*

Street Address

Street Address Line 2

CityCounty

Postcode
Date of Birth (DD-MM-YYYY)*

DayMonthYear
National Insurance Number*
Email Address*
example@example.com
Phone Number*
Bank Details

Please complete the below to provide your bank details for payroll purposes.
Full name of account holder*
Sort Code*
Account Number*
HMRC new starter checklist

You will now be expected to complete the HMRC Checklist, a link to the checklist as follows: https://www.gov.uk/guidance/starter-checklist-for-paye

If you are unable to complete this form online you will need to complete the paper version. Please click on the following link for a copy of the form in pdf format:

HMRC new starter checklist
I confirm I have completed the HMRC New Starter Checklist*

Confirmed
Next of Kin details (for use in emergency)
Name of emergency contact*
Phone Number*
Employee documents
Please upload a form of photo ID (i.e. passport)*

Browse Files

Cancelof
Please upload another form of photo ID*

Browse Files
This needs to be different from the above photo ID Cancelof
Please upload some ID which confirms your home address (i.e. a council tax bill).*

Browse Files
This must not be more than three months old from today's date Cancelof
If you are a driver, please upload your DRIVING LICENCE here (we are unable to allocate work to you if this is not uploaded - not applicable to walkers):

Browse Files

Cancelof
If you are a driver, please upload proof of your BUSINESS INSURANCE FOR CAR USE here (we are unable to allocate work to you if this is not uploaded - not applicable to walkers):

Browse Files

Cancelof
Health Declaration
Name & address of your GP surgery:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you give permission for us to contact your GP if the event of an emergency or should we require any additional information in order to support your wellbeing at work?

YesNoYes - however I would like you to let me know first if you are planning to do this
Do you have any health conditions or disabilities that you may require reasonable adjustments for to assist you to perform fully in your new role? (Please tick any of the following that may apply)*

Heart conditionSight conditionHearing lossBlood pressureAnaemiaPhysical disabilitySensory disabilityAutism/ASDDyslexiaAnginaBlood disorderMigraines/severe recurring headachesEpilepsy/seizuresMental health condition, such as Depression, Anxiety or suffer panic attacksSevere chest condition, such as COPDAsthmaEczema / Dermatitis/PsoriosisKidney failureRenal failureIssue relating to illicit drug or alcohol misuseBad backBad kneckOther musculo skeletal conditionDiabetes (Type 1)Diabetes (Type 2)ArthritisNo health issuesOther
Equal Opportunities

Lotus Home Care is committed being an equal opportunities employer and we welcome applications from all sections of the community. We would appreciate it if you could complete the following so we may support you in your role and ensure you have fair access to any work opportunities that may arise:
What is your age range:

18-2526-3536-5556+
What is your ethnicity? Ethnic origin is not about nationality, place of birth or citizenship. It is about the group to which you perceive you belong. Please tick the appropriate box

IndianPakistaniBangladeshiChineseAfricanCaribbeanWhite and black CaribbeanWhite and black AfricanWhite AsianWhite BritishIrishNorthern IrishEnglishScottishWelshPrefer not to sayOther
What is your sexual orientation?

StraightGayBisexualPansexualAsexualHeterosexualPrefer not to say
What is your religion or belief?

BuddhistChristianHinduSikhJewishMuslimPrefer not to sayOther
Do you have any caring responsibilities outside of work for a child or adult dependant?

YesNoSometimesOther
Which gender do you most identify with?

MaleFemaleInter-sexNon-binaryAgenderBi-genderGender-fluidTrans-genderPrefer not to sayOther
Do you consider yourself as having a disability (as defined in the Equality Act 2010)?

YesNoPrefer not to sayOther
If you have answered Yes to having a disability, are you able to share with us what that disability is?
If you have answered yes to having a disability, do you require any reasonable adjustments putting in place to support your wellbeing at work?

YesNoNot at the moment however this may change in futurePrefer not to sayOther
Is there anything else you would like to share with us that you think we may need to be aware of that may put you at an unequal disadvantage as a result of one or more protected characteristics? If there is, please state below:
Please leave blank if the answer is no.
Date when form completed*

MonthDayYear
Date
Name

First NameLast Name
Signature*

Clear
Should be Empty:

Lotus Home Care - Employee New Starter Form

Employee documents

Health Declaration

Equal Opportunities