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Better Healthcare Solutions, LLC
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At Better Healthcare Solutions, we are always looking to add qualified and dedicated professionals to our growing team. If you are interested in joining our growing team, simply fill out the form below. Allow us to review your application and we will provide you with feedback in a timely manner.
Applicant Information
Enter Applicants Name
*
Address
*
City, State and Zip code
*
Telephone
*
Email
*
Date of Application
Employment Position
Position(s) applying for
RN
LPN
CNA
STNA
HHA
PCA
Type of Employment
Full Time
Part Time
PRN
Contract Only
How did you hear about this position?
What days are you available for work?
What hours or shift are you available for work?
If needed, are you available to work overtime?
On what date can you start working if you are hired?
Do you have reliable transportation to and from work?
Salary desired
Personal Information
Have you ever applied to or worked for Better Healthcare Solutions before?
Yes
No
When?
Do you have any friends, relatives, or acquaintances working for Better Healthcare Solutions?
Yes
No
State name & relationship
Are you 18 years of age or older?
Yes
No
Are you a U.S. citizen or approved to work in the United States?
Yes
No
What document can you provide as proof of citizenship or legal status?
Will you consent to a mandatory controlled substance test?
Yes
No
Do you have any condition which would require job accommodations?
Yes
No
Please describe accommodations required below
Have you ever been convicted of a criminal offense (felony or misdemeanor)?
Yes
No
Please state the nature of the crime(s), when and where convicted and disposition of the case
(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)
Job Skills/Qualifications
Please list below the skills and qualifications you possess for the position for which you are applying
Education and Training
High School
Location (City, State)
Year Graduated
Degree Earned
College/University
Location (City, State)
Year Graduated
Degree Earned
Vocational School/Specialized Training
Location (City, State)
Year Graduated
Degree Earned
Military
Are you a member of the Armed Services?
What branch of the military did you enlist?
What was your military rank when discharged?
How many years did you serve in the military?
What military skills do you possess that would be an asset for this position?
Previous Employment
Employer
Job Title
Supervisor Name
Employer Address
City, State and Zip Code
Employer Telephone
Dates Employed
Reason for leaving
Employer Name
Job Title
Supervisor Name
Employer-Address
City, State and Zip Code
Employer
Dates Employed
Reason for leaving
Employer Name
Job Title
Supervisor Name
Employer Address
City, State and Zip Code
Employer Telephone
Dates Employed
Reason for leaving
References
Please provide 3 personal and professional reference(s) below:
Reference
Contact Information
Additional Information
Why should you be considered for this position?
What makes you the best candidate for this position?
Tell us a little about yourself
Do you have any experiences or knowledge that will benefit the company?
AT-WILL EMPLOYMENT
The relationship between you and the BETTER HEALTHCARE SOLUTIONS is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or the BETTER HEALTHCARE SOLUTIONS. No representative of BETTER HEALTHCARE SOLUTIONS has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Executive Vice-President/Chief Operations Officer or the Company's President.
Applicant Signature
*
Date
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