Nurse Call

Name: (required)

Phone number: (required)

Email: (required)

Postcode (required)

Are you a nurse or carer? (required)
NurseHealthcare Assistant

Have you worked in UK hospitals before? (required)
YesNo

Can you provide written evidence confirming immunity to HEP B, MMR, TB, Varicella? (required)
YesNo

Are you competent undertaking observations (healthcare assistants only)?
YesNoN/A

Can you provide work references covering the past 3 years? (required)
YesNo

Do you have a DBS on the update service? (required)
YesNo

Do you have an in-date Basic Life Support certificate (dated last 12 months)? (required)
YesNo

Do you have an in-date Moving & Handling certificate (dated last 12 months)? (required)
YesNo

Do you have an in-date Safeguarding Adults certificate (dated last 12 months)? (required)
YesNo

Do you have an in-date Safeguarding Children certificate (dated last 12 months)? (required)
YesNo

Do you have an in-date Equality & Diversity certificate (dated last 12 months)? (required)
YesNo

Do you have an in-date Food Hygiene certificate (dated last 12 months)? (required)
YesNo

What shifts do you prefer? (required)
EarliesLatesLong daysNights

How many shifts per week do you require? (required)
1234567

When are you available for work from? (required)
ASAP2-3 weeks4 weeks +

01522 412007 / 0116 296 0555

lincoln@staffaid.co.uk leicester@staffaid.co.uk

StaffAid, Greetwell Place, 2 Lime Kiln Way, Greetwell Road, Lincoln, LN2 4US

www.staffaid.co.uk