Bayview Healthcare Online Application

Post Applying for:*

How did you hear about this job?

Date available to start*

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Personal Information

Title*

First Name*

Last Name*

Middle Name

Email*

Phone Number*

Date of Birth*

National Insurance No:*

NMC Pin No: (Nurses Only)

Address*

Town / City

Postcode*

Personal Details

Nationality*

Gender*

Religion*

Race/Ethnicity*

Sexual Orientation*

Employment Eligibility

Are you permitted to work in the United Kingdom?*

Yes

Can you provide evidence to prove eligibility?:*

Yes

Please state what visa/permit you hold (If applicable):

Permit/Document No (If applicable):

Visa/Permit Expiry Date (If applicable):

Driving Details

Do you have full Driving Licence that allows you to drive in the UK?*

Yes

If yes, please enter your Driving Licence No:

Languages

English – Spoken*

Fluent

Good

Fair

English – Written*

Fluent

Good

Fair

Other Languages Spoken:*

Next of kin details

First Name*

Last Name*

Relationship:*

NOK Phone Number*

NOK Address*

Town / City

NOK Postcode*

Work History

We need up to 10yrs work history please with no gaps.

Previous Job Title / Position Held*

Date Previous Job Started*

Date Previous Job Ended*

Previous Job Description (Please list all other work history below, including start and end dates)

Education/Qualification History

Institution*

Course*

Year*

Grade*

Education (Please list all other education history below, including Courses, Years and Grades)

Upload CV if you have one.

References

Ref Name 1*

Relationship*

Ref 1 Email*

Ref 1 Phone Number*

Ref 1 Address*

Town / City

Ref 1 Postcode*

Ref Name 2*

Relationship*

Ref 2 Email*

Ref 2 Phone Number*

Ref 2 Address*

Town / City

Ref 2 Postcode*

Skills Experience & Training

Please click on which training you have completed and the date on the notes (certificates must be provided).

Health Declaration

Do you or have ever suffered from long term illness?:*

Yes

Have you ever required sick leave for a back or neck injury?:*

Yes

Do you suffer with any back or neck injuries?:*

Yes

Have you been in contact with anyone who is suffering from a contagious illness within the last six weeks?:*

Yes

Do you suffer with a communicable disease?:*

Yes

If you have answered ‘yes’ to any of the above, please give details:

Are you currently receiving active medical attention?:*

Yes

Are you registered disabled?:*

Yes

How many days have you been absent from work due to illness in the last 12 months?:

State reason(s) for absence:

GP Details

GP Name:

GP Surgery Name:

GP Address

Town / City

GP’s Postcode

GP’s Phone Number

May we contact your Doctor for health check?:

Yes

Please Note

The above information will be held in strict confidence. If you are aware of any health issue that you feel may affect your ability to undertake responsibilities of the post, it is your responsibility to inform the Care Manager immediately. Again any details discussed in the meeting will be held in strict confidence.

DBS Declaration

Do you have a current DBS (Disclosure Barring Service) certificate?:*

Yes

Please enter disclosure number

Date of issue

Reference Number (if applicable):

DBS Check*

I understand that a DBS check will be sort in the event of a successful application.

Terms of employment

If any provision of this Agreement should be held to be invalid it shall to that extent be severed and the remaining provisions shall continue to have full force and effect. You may be required to use personal vehicle to and from work. No fuel reimbursement will be given. You are responsible for meeting the cost of DBS Disclosure. The employer, in some circumstances, may agree to advance the cost only if you agree it to be deducted from your pay. Carers will achieve NVQ Level 2 within 2 years of the start of employment. All care staff and trainees, including all staff under 18, will register on and successfully complete Skills for care certified training programme. The Company has written and published a formal policy/procedure document covering employee grievances which relate to your employment. The document is entitled “Employee Discipline” and is available for review at any reasonable time. Please contact your Manager for further information, or to request to review a copy. If you are dissatisfied with any disciplinary or dismissal decision relating to you then you should, in the first instance, apply in writing, to the Care Manager stating the grounds for your appeal. The person who will consider the appeal may vary according to individual circumstances. The Company has written and published a formal policy/procedure document covering employee grievances which relate to your employment. The document is entitled “Employee Grievances” and is available for review at any reasonable time. Please contact your Care Manager for further information, or to request to review a copy. If a grievance cannot be resolved informally then you must put your grievance, in writing to your Care Manager. A simple form has been designed for this purpose. Employees with reading or language difficulties should seek assistance, for example, from a work colleague. Subsequent steps, including the right of appeal, are explained in the formal document. The following documents form part of this statement: Employee handbook Policy and procedure manual Notices

Terms of employment*

I have read and agree to the terms

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Bayview Healthcare Online Application Form

Welcome to Bayview Healthcare

Register with us by filling out the form below.

Bayview Healthcare Online Application

Personal Information

Personal Details

Employment Eligibility

Driving Details

Languages

Next of kin details

Work History

Education/Qualification History

References

Skills Experience & Training

Health Declaration

GP Details

Please Note

DBS Declaration

Terms of employment

Contact Us

Address

Service Timing