1320 NE 7th St. Grants Pass, Oregon 97526  Call Us Today: 541-479-0993 Home About Us Our Services Payment Accepted Hiring An Independent Caregiver Yourself vs. Hiring An Agency Employment Resources Contact Us Application Caregivers Make A Difference Everyday! Apply today to start your career as a caregiver. Step 1 of 4 25% Application Date(Required) MM slash DD slash YYYY Name(Required) First Last Home Phone(Required)Cell PhoneEmergency Contact Name(Required) Emergency Phone(Required)Address(Required) Mailing Address(Required) Email(Required) Check One Male Female Are You Over 18(Required) Yes No How Did You Hear About Us? Work Availability Home care is a 24 hour a day, 7 days a week business. AHC gives priority to applicants with scheduling flexibility. Please check the boxes to indicate your availabilitySunday(Required) Day Swing Noc Monday(Required) Day Swing Noc Tuesday(Required) Day Swing Noc Wednesday(Required) Day Swing Noc Thursday(Required) Day Swing Noc Friday(Required) Day Swing Noc Saturday(Required) Day Swing Noc HiddenUntitled How Many Miles Away From Your Home Are You Willing To Work ?(Required) Practical Experience: In order to place caregivers accurately, where they may provide safe and quality care, our agency must understand caregiver qualifications. Please read and honestly assess your experience below.Showers(Required) None Some Skill Excellent Bedbaths(Required) None Some Skill Excellent Incontinence Care(Required) None Some Skill Excellent Bedpan(Required) None Some Skill Excellent Catheter Care(Required) None Some Skill Excellent Colostomy Care(Required) None Some Skill Excellent Gait Belt(Required) None Some Skill Excellent Occupied Bed Change(Required) None Some Skill Excellent Turning/Positions(Required) None Some Skill Excellent Hoyer(Required) None Some Skill Excellent Oxygen(Required) None Some Skill Excellent Spoon Feeding(Required) None Some Skill Excellent Cooking(Required) None Some Skill Excellent Shopping(Required) None Some Skill Excellent Medication MGMT(Required) None Some Skill Excellent Insulin(Required) None Some Skill Excellent Housekeeping(Required) None Some Skill Excellent Check Any Job-Related Certifications and Provide A Copy:(Required) CNA RN LPN CPR First Aid Food Handlers Other Other Do You Have Any Other Skills That May Be Useful To The Position? Can You Lift 25lbs?(Required) Yes No Can You Lift 50lbs?(Required) Yes No Can You Provide Proof That You Are Either A U.S. Citizen Or Are Legally Permitted To Work In The United States?(Required) Yes No Do You Have A Valid Oregon Driver's License?(Required) Yes No Do You Have Proof Of Current Car Insurance?(Required) Yes No If You Do Not Or Cannot Drive, How Are You Planning On Getting To Work For Your Scheduled Shift(s)? Our Policy Is To Require At Least 2 References From Previous Personal Or Work Related To Verify Caregiving Experience. The References Cannot Be From Family Members.Work History: List Current Or Most Recent Employer First. We Must Have Dates Of Employment, A Contact Person And Contact's Phone Number.Employer(Required) Address Street Address City State / Province / Region ZIP / Postal Code Contact Person(Required) Contact Phone(Required)Date Employed From(Required) MM slash DD slash YYYY Date Employed To(Required) MM slash DD slash YYYY Title/Duties(Required) Reason For Leaving(Required) Employer(Required) Address Street Address City State / Province / Region ZIP / Postal Code Contact Person(Required) Contact Phone(Required)Date Employed From(Required) MM slash DD slash YYYY Date Employed To(Required) MM slash DD slash YYYY Title/Duties(Required) Reason For Leaving(Required) Employer Address Street Address City State / Province / Region ZIP / Postal Code Contact Person Contact PhoneTitle/Duties Reason For Leaving Employer Address Street Address City State / Province / Region ZIP / Postal Code Contact Person Contact PhoneTitle/Duties Reason For Leaving Do You Have Any Private Or Family Caregiving Experience, In Addition To The Information Listed Above? Please List Experience And If Possible, Leave The Names And Telephone Numbers, So We Can Call For A Reference.Upload Applicable Certification(s)Accepted file types: jpg, jpeg, png, pdf, Max. file size: 123 MB. Part-time and full-time positions available, both day and NOC shifts. Guarantee We follow HIPAA and privacy-protection laws and standards. Member Of Member ID: 406025 Licensed Oregon Health Authority Comprehensive in-home care agency license: 15-2349