Job Application

Job application
Thank you for applying for a job with LHG!

If you see a job listed on Indeed that interests you, we ask that you apply via Indeed first. However, if you would like to be considered with a general applicant pool, or if you have been directed by a member of the LHG staff to apply for a job with this form, please complete the fields below.
What type of role are you applying for?

CaregiverNurseTherapistOffice role
Name*

First NameLast Name
Address*
City*
State*
ZIP code*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
How did you learn about LHG?

Internet searchIndeedCurrent LHG employeeCurrent patientOther
Who referred you to LHG?

When are you available for work?

	Mon	Tues	Wed	Thurs	Fri	Sat	Sun
Morning (8a-12p)
Afternoon (12p-5p)
Evening (5p-10p)
Overnight (10p-8a)

How far are you willing to commute for a client?

0-10 minutes11-20 minutes21-30 minutesOver 30 minutes
Schedule preferences

I am willing to be considered for additional shifts/hoursI am willing to be contacted for "last-minute" shift opportunities
Please check all that apply to your background and experience

Certified Nurse Assistant (CNA) license activeGait Belt ExperienceHoyer Lift ExperienceDementia ExperienceHospice ExperienceIncontinence ExperienceCatheter Care ExperienceFeeding Tube Experience
Please check any care preferences or restrictions*

NOT comfortable with dogsNOT comfortable with catsNOT comfortable with client/patient smokingNOT comfortable driving a client/patient
Please upload your resume

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Licenses and/or Certifications (if applicable)

Examples: CNA, HHA, BLS, etc.
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Federal and state regulations require that employees of licensed healthcare entities pass a criminal background check prior to employment. If you would like to be considered for a role, please upload a current government-issued ID card and a picture of your social security card via the secure portal below.

For a list of approved forms for employment ID, please visit: USCIS
Current government-issued ID (Ex: Driver's License, Passport)*

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Social security card*

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Your signature below acknowledges that you have read, understood, and consent to the following:
- The information contained within this application is true and accurate
- I consent to a criminal background check as part of my application
- I am not aware of any pending actions that may negatively affect my ability to pass a background check or legally seek employment in the United States
Signature*

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Job application