Nursing Pre-Screen Application Georgia 🩺✨
Complete this quick form to express your interest in joining Caring Hands United.
Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Are you applying as an RN or LPN?
*
Registered Nurse (RN)
Licensed Practical Nurse (LPN)
Which Caring Hands United office location are you closest to?
*
Please Select
Atlanta
Augusta
Dublin
Griffin
Savannah
Are you interested in working office hours?
Yes
No
Which areas or populations are you interested in working with?
*
Pediatrics
Geriatrics
Skilled Nursing
Home Health
Special Needs
Hospice
Rehabilitation
Other
Do you have experience working with home care / home health clients?
*
Yes
No
Prior experience (please check all the apply)
*
Supervisory Visits
Admission Visits
Assessment / Reassessment Visits
Skilled Nursing Visits
Wound Care Visits
Medication Management Visits
Skilled Visits - Special Needs Patients
Tube Feeding
Health Coach (Family Caregiver Program)
Other / None of the Above
How far are you willing to travel (in miles)?
*
Up to 10 miles
Up to 25 miles
Up to 50 miles
Up to 75 miles
Up to 100 miles
100+ miles
Current employment status
*
Employed full-time
Employed part-time
PRN
Unemployed
Student
Current availability
*
Days
Evenings
Nights
Weekends
Flexible
How many hours per week are you seeking?
*
Less than 10
10-20
21-30
31-40
More than 40
Do you have an active Georgia nursing license?
*
Yes
No
Do you have reliable transportation?
*
Yes
No
Are you comfortable managing your own schedule to ensure all clinical deadlines are met independently, or do you prefer for the schedule to be set by office staff?
*
I prefer setting and managing my own schedule
I prefer for office staff to set the schedule for me
Additional comments (optional)
Please verify that you are human
*
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