Employment Application Form

Employment Application

Fill the form below completely and accurately indicating your potentials and suitability to job applying for.
Name:

First NameLast Name
Birth Date

MonthDayYear
Phone Number:

Area CodePhone Number
E-mail Address:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you willing to participate in a group interview? (NOTE: All Clinical Assistant and/or Receptionist/Front Desk positions are interviewed this way)

Other
Position Applying For:
We promote from within. All current senior employees started at entry-level positions
All positions require dependable transportation. Choose one of the following:

Other
How were you referred to us?
Others:
Upload CV or Resume: (this is required)

Upload a File

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Job Skills & Training
Describe your skills:
Training or Certifications:
References

Please list two (2) references that are familiar with your work life. (References must NOT be family)
Why do you feel we should hire you for this position above other applicants?
Reference 1
Name:

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Years Known:
Reference 2
Name:

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Years Known:
Clinical Assistant Position:

You are working with a patient and have instructed them to complete 2 sets of 10 of a particular exercise. The patient does about 6 reps and quits. When you ask the patient if they've completed 2 sets of 10 they tell you "yes I did" but you clearly saw that they are not doing their exercises. What do you do?
Type your answer here:
Clinical Assistant Position:

You have just been hired on as a Clinical Assistant and have completed your Training by the Clinic Supervisor. You are under the understanding that being dependable and coming to work on-time is a HIGH priority to this team. You notice that one of your new Team Members has been coming in on-time but not coming out to the gym to help with patient exercises until 10-15 min past their start time. This leaves you alone with multiple patients in the gym. What do you do?
Type your answer here:
Front Desk/Receptionist:

You had a great day today and noticed that you were able to fill the schedule for tomorrow and all your patients came in on time. They also all had great treatments, as always. You are finishing up balancing the cash box at the end of the day and after checking and re-checking five (5) times you notice that there is $20 missing from today's sales. You remember collecting a $20 bill from a patient for their copayment but are unsure of where it is now. How do you handle this situation?
Type your answer here:
Front Desk/Receptionist:

You have just been hired for the Receptionist position and are excited for your first week at a great company. You have been learning diligently during your orientation and shadowing experience and you're finally able to start doing small tasks on your own. You take a call from a patient who is frustrated and on the verge of anger because they haven't been seen in two (2) weeks and demand to get on the schedule immediately. You pull up the patient's chart and you notice that they have a history of canceling last minute and was a no-show for 2 previous appointments. How would you handle this situation?
Type your answer here:
What is the most difficult thing you've ever had to overcome in your life and what has it taught you?

Many companies SAY that they work as an 'Ohana and others claim to be a great TEAM.

WE actually ARE.
Our patients depend on us and we make a difference in their lives everyday.
We DEPEND on each other to be at work when you're supposed to be and do the best job you can while helping each other out.

We don't clock in/out for the paycheck.

We realize that all of our jobs are extremely important!

CORE VALUES

RESPECT

INTEGRITY

LOYALTY

BE THE EXAMPLE

ACCOUNTABILITY

HUSTLE

COMPETE EVERY DAY

DREAM BIGGER
If you are unable to commit yourself to a team that cherishes these values, please DO NOT submit your application.
We are NOT in the business of hiring warm bodies but rather, we are in the business of building the best team for our patients and our co-workers.

Mahalo Nui and Good Luck!
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Comments and/or Suggestions:
NOTE: your answers are confidential and will not be shared with anyone.

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Employment Application

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