subject_line
Name
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Phone number
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Email
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Are you 18 years or older?
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Do you have work experience as a caregiver; if yes, how many years?
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When can you start?
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What side of town do you live on?
A. North
B. South
C. East
D. West
or (another city)
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Do you want full-time or part-time?
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How many hours can you work a week? A. 5-10 hours B.10-20 hours C. 20-30 hours D. 30-40 hours
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How many days/nights can you work a week?
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Can you be a back-up for a caregiver that is not able to make it to their shift?
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Are you comfortable with pets?
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Do you have an active CNA/HHA license?
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Do you have an active TB test?
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Do you have a Driver's License?
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How will you get to work? A. self (have reliable car) B. find a ride C. Family D. Uber/bus
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Do you have car Insurance?
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Do you have CPR certification?
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Are you fine with being around a Client who smokes? Yes or NO
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