ABC Senior Services --Southwest Fairfield County Conn
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1.
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1
. Please provide the following:
Please provide the following:
Name
Phone number
email address
Physical address
*
2
. Do you have a minimum of 1 year healthcare industry experience?
Do you have a minimum of 1 year healthcare industry experience?
Yes
No
3
. If you answered "yes" to question #2, please describe your experience
If you answered "yes" to question #2, please describe your experience
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4
. Do you have experience providing care to someone other than a family member?
Do you have experience providing care to someone other than a family member?
Yes
No
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5
. Please describe any training or certifications you have that might assist you as a caregiver e.g. CNA, HHA etc.
Please describe any training or certifications you have that might assist you as a caregiver e.g. CNA, HHA etc.
*
6
. We work in Southwest Fairfield County Conn (Greater Greenwich, Stamford, Darien and New Canaan).--Is this convenient for you and do you have reliable transportation?
We work in Southwest Fairfield County Conn (Greater Greenwich, Stamford, Darien and New Canaan).--Is this convenient for you and do you have reliable transportation?
Yes
No
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7
. Do you have a valid driver's license?
Do you have a valid driver's license?
Yes
No
8
. What are your preferred working days/hours??--Multiple Choices are okay
What are your preferred working days/hours??--Multiple Choices are okay
Live in 24/7
Live in weekdays
Live in weekends
Weekdays (Mon/Friday) days
Weekdays (Mon/Friday) over night
Weekends (Sat/Sun) Days
Weekends (Sat/Sun) Nights
Other
9
. If you chose Other from question 8 above please let us know better what you prefer.
If you chose Other from question 8 above please let us know better what you prefer.
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