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Health Care Assistant

Estimated completion time: 20-30 minutes

Application #1 - HCA
  • Personal
  • Education
  • Employment
  • Skills
  • Health
  • Compliance
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Data Protection Statement

In order to comply with the terms of the Data Protection Act 1998 it is essential before completing this application form that you read the following statement, as registration acts as an acceptance of the statement below.

The agency will hold personal data relating to you. Such data will include your registration/ application form, references, address and contact details, bank details, work holiday and sickness records, next of kin details, pay and remuneration details and other records (which may, where necessary include sensitive data relating to your health and data held for equal opportunities purposes).The company will hold such information for personnel administration and compliance purposes and to comply with its obligations with regards to the retention of your records. Your right to access such data relating to you for personnel administration and compliance purposes and may, when necessary for those purposes, make such data available to its advisors, third parties providing products and/ or services to the company and as required by law.

I authorise Medicare Health Professionals Ltd to take references and to give its clients relevant information relating to my employment details or this registration. I confirm that to the best of my knowledge the information given on this form is correct. I understand that any misrepresentation or omission of any material fact or deception will be cause for immediate cancellation of membership and assignments.

Equality of Opportunity Statement

The Agency’s Equal Opportunities Policy covers all employees, or potential employees, and embraces the principle that all people shall be treated equally, regardless of their age, gender, ethnic origin, nationality, colour, religion, marital status, sexual orientation, religion or belief, disability, or offending background

Personal Details

Maximum file size: 268.44MB

Name
Name
First
Last
Mr/Mrs/Miss/Ms etc
Maiden name etc
Present Address
Present Address
City
County
Post Code
Country

Next of Kin

Next of Kin Address
Next of Kin Address
City
County
Post Code
Country

Right to Work

Are you a United Kingdom (UK), European Community (EC) or European Economic Area (EEA) National?
Please select the category that relates to your current immigration status.
This status will be subject to checking before your interview.
Does your visa have a condition restricting employment or occupation in the UK?
Please supply details of any visa currently held:

Bank Details

Bank Address
Bank Address
City
County
Post Code
Country
Employment & Education