Recruitment and Vetting At Wellness Care Provider, recruitment and vetting team ensures all our applicants are subject to a minimum of different checks before they join our service to ensures that we have the best and most determined staff. Wellness Application form Wellness Application FormPlease ensure that you complete the application form in full as we cannot accept incomplete applications. PreviousNextPersonal DetailsTitle- Select -MrMrsMissMsFirst NameLast NameDOBDo you prefer a Phone call or an email? Phone call EmailEmailPhone/MobileAddressAddress Line 1CityZip CodeCountrySelect CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)ReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweSave & ResumePreviousNextI understand this role may include: Shift work, Unsociable Hours, Lone working involved. Yes NoPlease Select preferred days.ThursdayTuesdaySaturdaySundayFridayWednesdayMondayDo you have a valid driver's Licence? Yes NoDo you own a Car? Yes NoAny Endorsements Yes NoPlease briefly tell us what happened.Are you a United Kingdom (UK) National? Yes NoUpload your ID (s).Choose File If NO, please provide details of your current immigration status here.Are you related to any member of staff or Service Users? Yes NoIf YES, please detail your relationshipEquality Act 2010 - Under the Equality Act 2010, the definition of disability is if you have a physical or mental impairment that has a “substantial” and “long-term adverse effect” on your ability to carry out normal day-to-day activities. Further information regarding the definition of disability can be found at: www.gov.uk/definition-of-disability-under-equality-act- 2010.For the purposes of this application and interview stage only, is there anything you would like us to be aware of so that we can make reasonable adjustments during the process? Yes NoIf YES, please explainSave & ResumePreviousNextEducation HistoryAll qualifications will be subject to a satisfactory check. Repeater Field Institution Start Date Finish Date Qualification Do you have any supporting documents? Yes NoUpload any supporting documentsChoose File Training CoursesAttended or completed online (evidence of attending or attended courses is required). Repeater Field Course Taken Location Date Details OnlineBuilding Upload any supporting documentsChoose File Save & ResumePreviousNextEmployment HistoryPlease record below the details of your full employment history beginning with your current or most recent first. Any gaps must be explained. Your employment History Start Date End Date Salay (Optional) Job Role Company Name Why you Left? Upload any supporting documentsChoose File Use this section to detail any gaps in employment and whySave & ResumePreviousNextReferences:Please provide names, addresses and telephone numbers for referees below whom we may approach for a reference. All will be contacted. Therefore, please inform the referees of the fact that you have used their name. If you are unable to provide the required references, please discuss the matter with us.Referee One Referee TwoReferees Referee Name Your Email Phone Number Company Name Occupation Save & ResumePreviousNextSafeguarding / Ex-Offenders Declaration:Please note this section will only be seen by those involved in the recruitment process and will be treated with the strictest confidence. The Rehabilitation of Offenders Act 1974 aims to promote equality of opportunity and is committed to treating all applicants fairly regardless of ethnicity, disability, age, gender or gender re-assignment, religion or belief, sexual orientation, pregnancy or maternity and marriage or civil partnership. Crossover Care Limited undertakes not to discriminate unfairly against applicants on the basis of a criminal conviction or other information declared.Answering 'yes' to the question below will not necessarily prevent your employment. This will depend on the relevance of the information you provide in respect of the nature of the position and the particular circumstances.Are you currently bound over or do you have any current UNSPENT convictions that have been issued by a Court or Court-Martial in the United Kingdom or in any other country? Yes NoDo you have any current UNSPENT police cautions, reprimands or final warnings in the United Kingdom or in any other country? Yes No I consented to have this website store my information so they can respond to my inquirySave & Resume Previous Submit Form