Healing Hands Home Care, LLC Employment Application Logo
  • Caregiver Employment Application

    Caregiver Employment Application

  • INSTRUCTIONS: Complete all questions (pages 1-4) Print all information requested except signature. Save and email to healinghandshomecare@3hchealthcare.com  

  • Personal Information

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  • Education Information

  • In Case of Emergency, Please Contact:

  • Driving Information

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  • Personal Reference Information

  • List two personal references. DO NOT LIST relatives or previous supervisors.

  • Work Experience

  • Please list at least two of your work experiences in the past five years beginning with your most recent job held. If you were self employed, give company name. Attach additional sheets if necessary.

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  • Skill Information

  • How would you rate yourself on your experience with the following aspects of caregiving? 1 = No Experience 2 = Some Experience 3 = Good Experience 4 = Excellent Experience

  • APPLICATION FORM WAIVER

    Please read carefully
  • In exchange for the consideration of my job application by Healing Hands Home Care, LLC (hereinafter called “3HC”), I agree that: Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other 3HC company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of 3HC, or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President of the 3HC. Both the undersigned and 3HC may end the employment relationship at any time, without specified notice or reason. If employed, I understand that 3HC may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits.

    I also understand that (1) 3HC has a drug and alcohol policy that provides for pre-employment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job related physical examinations.

    I understand that, in connection with the routine processing of your employment application, 3HC may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics, and mode of living. Upon written request from me, 3HC will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act.

    I hereby release any and all prior employers or current employers from liability or claims arising out of the provision of information about my employment with such employer. I hereby waive any cause of action I might otherwise have against such employer arising out of the provision of information concerning my employment.

    I further understand that my employment with 3HC shall be probationary for a period of sixty (60) days, and further that at any time during the probationary period or thereafter, my employment relation with 3HC is terminable at will for any reason by either party.

    I CERTIFY THAT ALL ANSWERS GIVEN BY ME ARE TRUE, ACCURATE AND COMPLETE. I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give 3HC permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release 3HC from any liability as a result of such contract.

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  • 3HC is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this depends solely on your qualifications.

      

    Thank you for completing this application form and for your interest in our business.

    Please return this application via email to our office at your earliest convenience.

    HEALINGHANDSHOMECARE@3HCHEALTHCARE.COM

    Phone 248-677-1191

    www.3hchealthcare.com

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