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Personal Details

Enter your details as they appear on your documents.

References

References are normally requested for candidates selected for interview. Please provide the name and email address of at least one work-related referee. This should normally be your current employer or, if you are currently unemployed or self-employed, your most recent employer.

References

References are normally requested for candidates selected for interview. Please provide the name and email address of at least one work-related referee. This should normally be your current employer or, if you are currently unemployed or self-employed, your most recent employer.

References

References are normally requested for candidates selected for interview. Please provide the name and email address of at least one work-related referee. This should normally be your current employer or, if you are currently unemployed or self-employed, your most recent employer.

References

References are normally requested for candidates selected for interview. Please provide the name and email address of at least one work-related referee. This should normally be your current employer or, if you are currently unemployed or self-employed, your most recent employer.

References

References are normally requested for candidates selected for interview. Please provide the name and email address of at least one work-related referee. This should normally be your current employer or, if you are currently unemployed or self-employed, your most recent employer.

References

References are normally requested for candidates selected for interview. Please provide the name and email address of at least one work-related referee. This should normally be your current employer or, if you are currently unemployed or self-employed, your most recent employer.

References

References are normally requested for candidates selected for interview. Please provide the name and email address of at least one work-related referee. This should normally be your current employer or, if you are currently unemployed or self-employed, your most recent employer.

References

References are normally requested for candidates selected for interview. Please provide the name and email address of at least one work-related referee. This should normally be your current employer or, if you are currently unemployed or self-employed, your most recent employer.

DBS

Any applicant who cannot provide a valid DBS certificate or a full immunisation record will be required to obtain these at their own expense. The company will cover the cost of mandatory training updates. However, cancellations made less than 48 hours before training, or failure to attend, may result in the cost being charged to the candidate.

Uniforms

Candidates may be required to purchase uniforms at a cost of £30. This amount will be deducted from your timesheet after you commence employment. Please indicate your required uniform size and quantity by completing the section below.

Health Declaration

Applicants applying for roles that involve Exposure Prone Procedures (EPPs) must provide satisfactory evidence of immunity to, or freedom from, Hepatitis B infection. Evidence must be provided in the form of a laboratory blood test result or a letter from your GP, Occupational Health Service, or previous Occupational Health provider confirming immunity or freedom from infection.

Please indicate whether you have ever had any of the conditions listed below.

Healthcare workers who are infected with HIV must remain under regular medical and occupational health supervision (Reference: Department of Health, 1994).

GP Details

I understand that my GP may be contacted regarding my health.

The information provided above will be treated in the strictest confidence. If you have any health condition or concern that may affect your ability to carry out the duties and responsibilities of the role, it is your responsibility to inform the Compliance Manager immediately. Any information disclosed to the Compliance Manager will be treated as confidential and handled in accordance with applicable data protection requirements.

Declaration

1. I declare that, to the best of my knowledge, the information provided in this application form, together with any accompanying documents submitted, is true, accurate, and complete. I understand that any false, misleading, or omitted information may result in the withdrawal of any offer of employment or, if employed, disciplinary action up to and including dismissal.

2. I consent to a medical assessment and interview if deemed necessary as part of the recruitment process.