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To register with PH Staffing, please fill out the form below:
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Indicates required field
Position applying for:
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Healthcare Assistant
Care and Support worker
Care Team Leader
RGN
RMN
Title
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Mr
Mrs
Miss
Ms
Dr
Full name (including middle names):
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Do you have an experience within the role you are applying for?
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Full address (including postcode):
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Email:
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Mobile No:
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Is the mobile number above linked to your WhatsApp account?
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Yes
No
If no, please enter your WhatsApp number below:
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National Insurance No:
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Upload valid ID (passport, birth certificate, valid UK driving licence):
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Max file size: 20MB
Upload your valid Right to work document:
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Max file size: 20MB
Do you consent PH Staffing to check your immigration status online, if so, please enter your immigration status share code below:
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Upload proof of your address (utility bill or bank statement no older than 3 months, driving licence):
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Max file size: 20MB
Upload proof of your bank details (Bank account opening letter, bank statement no older than 3 months)
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Max file size: 20MB
Upload your up to date CV (EXPLAIN ANY EMPLOYMENT GAPS)
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Max file size: 20MB
Next of kin contact details (relationship to you, full name, mobile number, email address):
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Do you hold valid UK driving licence?
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Yes
No
Availability to the car?
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Yes
No
Have you been convicted of a criminal offence or received a caution, warning or reprimand?
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Yes
No
Upload proof of your NI number (NI letter, payslip, P60:
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Max file size: 20MB
Upload good quality passport size photo of you:
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Max file size: 20MB
Upload your valid driving licence (if applicable):
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Max file size: 20MB
If yes, please provide the date:
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Is your DBS registered with the DBS Update Service?
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Yes
No
N/A
Do you give consent to PH Staffing to check your DBS certificate online?
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Yes
No
N/A
Please enter your DBS certificate number and issue date (if applicable):
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Please tick each task in which you are experienced. Personal hygiene:
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Bath/shower/strip wash/bed bath
Care of hair
Shaving
Mouth care (inc. dentures)
Care of feet (excl. toenails)
Care of fingernails
Dressing/undressing
Care of eyes
Nutrition:
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Preparing meals
Assisting with meal
Food handling
Food presentation
Medication:
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Level 1 Prompt/Assist
Level 2 Administer
Level 3 Administer using specialist techniques
Instillation of eye, nose and eardrops
Continence Management:
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Continence care
Bedpans/commodes etc.
Changing a catheter bag
Stoma care
Mobility:
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Lifting and handling
Use of hoist (manual/electric)
Support with walking aids
Moving of service users
Monitoring:
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Water temperature
Fluid intake
Nutritional intake
Urine output
Bowel movements
Administrative Abilities:
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Report writing
Recording instructions from GP/nurse
Recording changes in service user’s condition
Practical Tasks:
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Light housework
Washing laundry
Shopping
Bed making/changing a bed
Collecting benefits
Areas of Specialism:
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Older people
Palliative Care/ End of life
Physical disability
Supporting service user with infectious diseases
Mental health
Learning disabilities
Children and young people
Other
Other, please specify:
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Working Times Regulations Declaration. DO you wish to work more than 48 hours per week? By saying YES you Opt-out from of the 48-hour weekly limit.
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Yes, I DO wish to work more than 48 hours per week and I want to opt-out
No, I do NOT wish to work more than 48 hours per week
Employment reference 1 (Name of the company, Referee's full name, professional relationship to you, telephone No, email address):
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Employment reference 2 (Name of the company, Referee's full name, professional relationship to you, telephone No, email address):
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PH Staffing is registered with ICO and all your personal data collected will be treated as confidential.
ICO Registration No: ZA564945
Submit
Home
About Us
STAFF
JOIN US
JOIN US
APPLICATION FORM
EQUALITY & DIVERSITY MONITORING
HEALTH DECLARATION
PHS ACADEMY
PHS ACADEMY
Sign in Attendance Register
Sign Out Attendance Register
LEARNERS' EQUALITY & DIVERSITY
Privacy
Contact