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Telephone Number:

General Enquiries – 020 8514 1319

Service User Support – 020 8514 1319

020 8594 4018
Fax Number:020 8911 6434

E:info@pacificcareserviceslondon.co.uk

Postal Address:

Address 80 Abbey Road,
Barking,
Essex
IG11 7BT

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Care Workers Registration

Download Application Form

DBS Requirements

Care workers registration

Title:

Name:

Address:

Telephone:

Mobile:

Email Address:

Age:

Gender:Male Female

Qualifications:

Number of Years Experience:

Please briefly outline your experience:

What types of support can you provide? Personal care (inc.bathing and dressing) Domestic Support Administration & Correspondence Sitting/Respite Care (inc. live-in care) Social Care

Please explain in detail what hours or days you can work:

Can you provide any other support that is not listed above?

Would you like the care services you receive to be provided on a full or part-time basis, or as and when required? Full Time Part Time As and When Required

Please list any language or communication requirements you may have:

Do you hold a full UK driving license? Yes No

Do you have any specific requirements with regard to your work? (such as physical, religious or cultural factors)?

Are you able to carry out manual handling or other heavy tasks? Yes No

Can you provide proof that you can work legally in the UK? Yes No

Additional information or skills

Personal reference

Professional reference

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Care workers registration