Apply To Be A Self Employed / Independent Contractor
for Bamboos Approved HealthCare Personnel

Declaration

  • Application
  • Details
  • Declaration

Basic Info

I am applying my services for the role of:

First name

Last name

Mobile no.

Email

Address

Postal code

Gender

Date of Birth (in DD-MM-YY format)

Place of birth

Marital Status

Height

Weight

Spoken Language(s)

NRIC

Religion

Are you a Singapore PR?

Are you a Singaporean?

License

SNB License No. (For Nurse) / AHPC License No. (For Physiotherapist)

License Expiring Date

BCLS

Personal Details

Hobbies

Do you have children and how many?

How many siblings do you have?

Health Details

Do you have or were you ever diagnosed with any of the following conditions? (tick all that apply)

Other conditions (ex: Thyroid | Migraine | Chronic Pain | Any condition that requires regular medication, please specify)

Are you pregnant?

If YES, how many months:

Educational Level

Highest Educational Level

Year of Graduation

Number of years studies

FOR NURSE ONLY

Which nursing school did you go to:

Year of Graduation

Number of years studies

What Nursing Degree / Diploma did you obtain:

Year of Graduation

Number of years studies

FOR CAREGIVER ONLY

Which CareGiving Course did you go to:

Date of Certification

Number of hours studies

FOR PHYSIOTHERAPIST ONLY

Which Physiotherapy school did you go to:

Year of Graduation

Number of years studies

What Physiotherapy Degree / Diploma did you obtain:

Year of Graduation

Number of years studies

Criteria for Physiotherapist: AHPC License with at least 2 years working experience & possess qualification recognised by the AHPC

If Others, please specify:

Employment

Number of Active Years Working

Number of Active Years in Nursing

Current Employer

Job Title

Have you worked as a Caregiver before? Please give details (where, when, etc.)

Specialisations / Experiences:

Others (please specify)

Procedural Skills

Others (please specify)

Other working / healthcare experience:

Job Commitment Level (kindly update us on your monthly roster to get best matching opportunities)

Available Days:

Available Timing:

Referred by:

Approved Healthcare Personnel No.:

Declaration

You are required to provide your services to Private Homes, Nursing Homes, Hospitals, Healthcare Organisations For: :

  • Personal Care & Services
  • Geriatric, Chronic & Palliative Care & Services
  • Elderly Care & Services
  • Post-Surgery Care & Services
  • Disabled Care & Services
  • Maternity Care & Services

You are required to provide the following services:

  • Daily Activities & Exercise
  • Companionship
  • Out-Patient Escort
  • Medication Reminding & Recording
  • Light Groceries for Meal Fixing & Feeding
  • Showering & Dressing
  • Night Observation Care (optional)

REMARKS:

By submitting this form, I hereby acknowledge that I have completely read and fully understand the above information. I certify that all statements made by me on this application are true to the best of my knowledge. I also understand that any false statements on this document may be grounds for disqualification from being approved as Bamboos Independent Contractor / A Self-Employed HealthCare Personnel.


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