CAREGIVER EMPLOYMENT APPLICATION

By filling out this application and questionnaire, you are applying for employment at Pyrimed Care Services. This company is dedicated to a policy of non-discrimination of applicants on any basis including race, color, age, sex, religion, disability, medical condition, national origin, or marital status.

Alternate Contact
Transportation

Most clients require transportation, often using the Care Provider’s vehicle:

Availability
What Education Qualifies You To Work As a Caregiver?
What is Your Past Experience?
Skills

Please indicate which of the following skills you are prepared to provide if referred to seniors / families:

  • Companion Care & Safety
    Medication reminders
    Oral Care
  • Alzheimer’s
    Transportation
    Shaving Assistance
  • Dementia
    Bathing (Reg., bed, sponge)
    Assist w / P.T. Exercises
  • Meal Prep / Clean Up
    Dressing/ Grooming
    Assist w/ Prosthesis
  • Feeding
    Incontinence
    Hospice
  • Light Housekeeping
    Ambulation
    Willing to Work w/Pets
  • Laundry
    Transfer assist
    Speak fluent English
Work History

Please provide at least five years of recent, verifiable work history followed by verifiable references.

Business | Professional References
Character & Personal References