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Senior Care Connect Caregiver Sign Up

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First name *

Last name *

Email *

Password *

Phone number

What is your availability to work (i.e weekends, Monday to Friday, evenings only, certain days of the week etc) *

What areas of the city would you work in (i.e Scarborough, Downtown, North York, Markham, Pickering etc) *

Submit a photo of yourself (jpg, png)

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Max File Size 15MB

Submit a video of yourself (mp4)

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What is your professional designation (i.e PSW, RPN, nursing student, PSW student, etc) *

Certification Document (pdf)

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Max File Size 15MB

Resume (pdf)

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Other Supporting Document. CPR or other training etc. (pdf)

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Max File Size 15MB

Do you have a clear police screen/check done within the last 12 months? *

Yes

Upload police check (pdf)

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Max File Size 15MB

What type of help/assistance are you able/trained to provide to clients? *

Bathing Assistance

Dressing

Toileting

Cleaning/Housekeeping

Grooming (i.e Brush/Wash Hair, Brush Teeth, etc)

Companionship (Social Engagement, Play Games, Observer/Sitter, Conversation, Walks, etc)

Assist with Mobility

Transfers

Accompany to Medical Appointments

Driving (able to drive client to appointments, groceries, etc)

Meal Preparation

Medication Reminders

Home Renovations

Other:

What language(s) do you speak? *

English

French

Mandarin

Cantonese

Korean

Spanish

Vietamese

Tamil

Punjabi

Gujarati

Bengali

Urdu

Arabic

Farsi

Portuguese

Italian

Russian

Polish

Greek

German

Other:

How many years of experience do you have providing care to elderly/seniors? *

How much do you charge per hour? (i.e $18/hr, $21/hr, etc) *

Families often want to know about a caregiver's personality to help match the right person with their loved one. Please share some of your interests or hobbies? (Example: Travelling, Reading, Playing soccer, spending time with family, going to the movies, etc) *

What made you decide on a career in caregiving/Why did you want to become a caregiver? *

Other Comments

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Currently serving the Greater Toronto Area

Mailing Address:
169 Enterprise Blvd., Unit 300

Markham, ON, L6G 0E7. Canada

1-800-397-5130

Info@SeniorCareConnect.ca

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