Join Our Team!

Healthy Life Services DSP
Application

What we offer to Healthy Life Services DSPs:

- Flexible Schedules

- Competitive Pay

- Benefits for FT (once qualified)

- Retirement (+max contribution match)

- PTO, Sick Leave & Bonuses

- Ongoing coaching and job support

- Regular training opportunities

- Community support

- Resources to help you love your job

First Name

Last Name

Date of Birth

Email Address

Phone

Available Start Date

Were you referred by somone?

Preferred Contact Method

Mobile

Both

Willing to work with:

Both Male or Female

Female Only

Male Only

Are you currently working another Full Time Job?

Emergency Contact:

Are you COVID Vaccinated? (This information is used for client preference matching only.)

Yes

Prefer not to say

Are you bilingual?

Yes

What certifications (current or prior) do you have?

CPR

First Aid

Mandatory Reporter

Oregon Intervention System (OIS)

Do you have personal care experience with any of the following:

Ambulation Experience:

Stand Assist

Slide Board

Hoyer

Gait-Belt Assist

Cognitive Experience:

Verbal Cueing

Redirection

ADD/ADHD

Autism

Are you okay working around/with pets?

Dog(s)

Cat(s)

Lifestyle Preferences:

Are you willing to work with clients who smoke?

Are you a "good" cook?

Do you have diabetic care experience?

Equipment Experience:

Catheter (emptying/cleaning)

Colostomy/Ostomy Bag (emptying/cleaning)

Yes, I will work with specialized equipment.

How long have you lived at your current address?

Have you lived outside of Oregon in the last 5 years?

Yes

Social Security Number:

Are you at least 18 years of age?

Yes

Do you have a High School Diploma (or educational equivalent)?

Yes

Have you ever worked for Healthy Life Services before?

Yes

List any foreign languages you speak and your level of fluency:

List any special skills/abilities you have that can be applied to this position:

Professional Reference: (#1)

Professional Reference: (#2)

How long have you known Reference #1?

How long have you known Reference #2?

Reference #1 Business:

Reference #2 Business:

Reference #1 Email:

Reference #2 Email:

Reference #1 Phone Number:

Reference #2 Phone Number:

Do you have a current driver's license in good standing?

Yes

Do you have current proof of auto insurance?

Yes

Are you willing to undergo a state mandated background check?

Yes

Thanks for submitting!

Join Our Team!

Healthy Life Services DSP Application

Healthy Life Services DSP
Application