Employment

Become a part of our team.

It is the policy of Appalachian Hospice and Home Health Services to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex, religion, national origin, disability or other protected classification.

Application for Employment

First Name

Last Name

Phone Type

Phone Number

Address 1

Address 2

City

State

ZIP Code

Have you ever been employed by this agency?

How many hours per week are you available to work?

Willing to work overtime as required?

Any hours, shifts, or days you cannot or will not work?

Are you willing to work overtime as required?

Are you willing to work evenings/weekends if needed?

Legally eligible for employment in the United States?

How did you learn of our organization?

Position applying for

If 'other' please specify

If applying for RN position please provide brief job history as a nurse?

If applying for RN position what year did you graduate?

If applying for an Aide position, are you currently certified?

License in Good Status?

Any action ever taken against license?

License Number:

Was your last name different from your present one during any earlier jobs?

If yes, what was your name?

Currently employed? If so where?

May we contact your current employer?

Do you have reliable transportation if required?

Personal References

Comment

Have you been convicted of a crime in the past 10 years, excluding misdemeanors and summary offenses, which have not been annulled, expunged or sealed by a court?

If yes, describe in full

Have you ever been tried and/or convicted of any charges that are drug related?

Are you capable of performing the job duties you have applied for?

Upload your resume

Appalachian Hospice and Home Health Services is certified by the Centers for Medicaid and Medicare Services and is a member of both the National Hospice and Palliative Care Association and the Kentucky Association of Hospice and Palliative Care.

Appalachian Hospice and Home Health Services adheres to all HIPAA privacy policies.

Employment

Become a part of our team.

Application for Employment

Services are available regardless of age, race, religion, national origin, color, sex or handicap

Success! Thank you for your application.