Employment Form

POSITION DETAILS

Type Of Position*

APPLICANT’S PERSONAL DETAILS

Surname*

Name*

Date of Birth*

Town & Country Of Birth*

Please List Languages Spoken Or Written Fluently*

Email*

CONTACT INFORMATION

Postcode*

Phone

Address*

EMERGENCY CONTACT DETAILS

Surname*

Name*

Relationship*

Phone*

RIGHT TO WORK DETAILS

Are You*

Australian Citizen
Permanent Citizen

VISA Type

Restrictions On VISA

OTHERS:

Max. file size: 2 MB.

PLEASE ATTACH EVIDENCE OF VISA DETAILS

QUALIFICATIONS WITH DATES COMPLETED

Date Completed	Qualification

EMPLOYMENT HISTORY WITH PLACE OF WORK AND DATES

Date	Place Of Work

BANK DETAILS

Bank Name*

Branch*

BSB Code*

Account Name*

Account Number*

HEALTH STATUS

If Required, Are You Willing To Attend A Medical Health Screening To Assess Your Capacity To Carry Out Duties Of This Position?*

Yes
No

Do You Have Any Injury Or Disability Which Requires Adjustment To Work Place*

Yes
No

Have You Been Exposed To Or Screened Or Vaccinated For Any Of The Following Conditions*

Please Attach Your Evidence Of Vaccination To This Application*

Max. file size: 2 MB.

Name Condition

REFEREES

CONSENT

1. I authorise Integral Home Care to contact my referees

2. I understand/acknowledge that I have had explained to me the purpose of collecting and/or disclosing my personal information; and also understand that I may request access to and /or correct any personal information held by IHC

3. I give Integral Home Care to take photographs for ID purpose and also for use by IHC Facebook/handbook/newsletter purposes.

Name*

Date*

Signature*

PRIVACY POLICY

the undersigned acknowledge that I understand and agree that I will not obtain, use or disclose information in any other way which is contrary to the conditions set out below.
All information concerning our Clients, our staff and our volunteers, and the business records of INTEGRAL HOME CARE (IHC) is confidential.
In the course of employment you may be involved in the collection of or have access to Client personal information. This information is to be kept confidential at all times. The names of Clients, families and staff, all information about them and information on the services they are receiving must not be disclosed or discussed with other Clients, family members or other people not involved in the provision of services to that individual.
You may only release this information about Clients to:
1. IHC Manager
2. IHC Supervisor
3. persons directly involved in the care of the Client
If further information is required about a Client in order to provide a service, this should be discussed with the Manager and only obtained from the Client, the Client’s representative, or the appropriate health care professional.
A breach of confidentiality is a serious betrayal of trust and if proven it will lead to disciplinary action and in some cases, civil action.

Name*

Date*

Signature*

EMPLOYMENT AGREEMENT

I, the undersigned

certify that the above details are correct. Any statement on this form which is found to be deliberately misleading will make me, if employed liable to dismissal and / or prosecution for any relevant offense

acknowledge I have been provided with information on specified infectious diseases, risk and consequences of exposure and protective measures I can take. I accept the responsibility of undertaking recommended screening and / or vaccination and providing INTEGRAL HOME CARE with any results

understand and agree to:

notify the Manager of any changes to details provided on this form as soon as a change occurs during the course of employment

provide evidence of protection against specified infectious diseases and TB screening undertaken during the course of employment

not come to the Home/client care if feeling unwell or diagnosed with a contagious infection or gastroenteritis

practice good hygiene techniques while on duty (i.e. regular hand washing, use standard precautions, and use gloves when handling food)

comply with Work Health and Safety requirements

perform those duties listed on the job description issued to me by INTEGRAL HOME CARE

sign the attendance book (or scan on / off) upon arriving and leaving the Facility/Client

notify the IHC Manager as soon as possible if I am going to be absent

wear the identification badge at all times when I am on duty for INTEGRAL HOME CARE

be punctual and conduct myself in a professional manner

not come to the Home/client care under the influence of drugs or alcohol

maintain, at all times, the safety, well being and dignity of the Clients/clients/staff/self

not accept payment or gifts of any kind from a participant. Staff not to handle money of participants against advice. Staff not to give any financial advice to participants.

notify the Manager when resigning and to return the Identification Badge and all other property of INTEGRAL HOME CARE to the Manager

Name*

Date*

Signature

POSITION DETAILS

APPLICANT’S PERSONAL DETAILS

CONTACT INFORMATION

EMERGENCY CONTACT DETAILS

RIGHT TO WORK DETAILS

QUALIFICATIONS WITH DATES COMPLETED

EMPLOYMENT HISTORY WITH PLACE OF WORK AND DATES

BANK DETAILS

HEALTH STATUS

REFEREES

CONSENT

PRIVACY POLICY

EMPLOYMENT AGREEMENT

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