Apply for Caregiver - Birmingham, AL

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:Caregiver - Birmingham, AL
ID:1001
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone xxx-xxx-xxxx:
* Email:
Attachments
Cover Letter:
You can type in a Cover Letter or Copy/Paste from an existing document.
LHC Online Application
* How did you hear about Lipford Home Care?
If you are responding to a job posting on Indeed.com, please list the specific job posting you are interested in.
* Are you 21 years of age or older?
Yes
No
* In what cities (areas) are you willing to work? Select ALL that apply.
Central (Homewood, Hoover, Vestavia, Mountain Brook)
North (Gardendale)
West (Bessemer, McCalla)
East (Trussville)
South (Alabaster, Pelham)

Schedule

* Shifts available:
Days
Evenings
Overnight
Weekends
Short Shifts (4 hours)
Short Notice
* Days of week available:
  
  
  
  
  
  
Additional comments about your availability:

Transportation

* Do you have an automobile?
Yes   No
* Do you have a driver's license?
Yes   No
* Do you have automobile insurance?
Yes   No

Certifications / Experience

* Are you a CNA?
Yes   No
* Do you have at least two (2) years experience working with older adults?
Yes   No
* If so, how many years of caregiving experience do you have?
* Please describe your experience working with older adults?
* Are you working now?
Yes   No

Previous Employment
(List last 3 positions with most recent first)

* Employer/Client Name:
* City/State:
* Job Title:
Month/Year Started:
Month/Year Ended:
* Reason for Leaving:
Employer/Client Name:
City/State:
Job Title:
Month/Year Started:
Month/Year Ended:
Reason for Leaving:
Employer/Client Name:
City/State:
Job Title:
Month/Year Started:
Month/Year Ended:
Reason for Leaving:
Skills
Homecare Experience
Facility Experience
Bed Bath
Transfers/gait belt
Mechanical lift
* Are you able to perform the essential functions of a Caregiver without limitations?
Yes   No
Experience with
Alzheimer’s/Dementia
Hospice
Men
Women
If No, please explain:
Willing to
Personal Care
Meal Preparation
Light Housekeeping
Shopping
Pet Care
Wear Scrub

Background

* Are you a citizen of the United States?
Yes   No
* Are you authorized to work in the United States?
Yes   No

LIPFORD HOME CARE requires a thorough Criminal Background Check and drug screen.

* Are you willing to have a check conducted on your background and submit to a drug screening?
Yes   No
* Have you ever been convicted of a felony or misdemeanor?
Yes   No
If Yes please explain.

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