Job Application: Health Care Assistant OL6

Title: Health Care Assistant OL6

Fields marked with an asterisk (*) must be filled out before submitting.

Position Applying For?

Personal Details

Title *
First Name *
Last Name *
Address *
Postcode *
Town/City *
County *
Email *
Date Of Birth *
Telephone *
Mobile

Work Details

Are you eligible to work in the UK? * Yes
No
Do you drive? * Yes
No
Hours Requested * All
Days
Nights
Weekends

Vaccinations (If you are applying for work in hospitals)

Hepatitis B? * Yes
No
MMR? * Yes
No
Chicken Pox (Varicella)? * Yes
No
Blood Test
Vaccination
TB? * No
Scar Seen
BCG Vaccine
Heaf/Mantoux
Rubella? * No
Blood Test
Vaccine

Additional Information

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Where did you hear of Apexhsc *
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CQC

Apex Head Office
5 The Parks
Haydock
WA12 0JQ
United Kingdom

Tel: 0845 600 3041
Fax: 0844 334 0810
Email: [email protected]