DECLARATION
I declare that the information I have provided on this application form is true. I understand that all personal information about me relating to my employment with Angel Heart Home Care is confidential.
I hereby give my permission for the information I have supplied to be made available, on a need to know basis, the Care and Quality Commission and those responsible in Social Services.
I agree to a medical examination or report, or to respond to a request for further information, if I am offered employment by Angel Heart Home Care. If necessary I authorise Angel Heart Home Care to contact my own doctor, consultant or specialist to whom I have been referred. I accept that any information submitted by Angel Heart Home Care as a result may be used to determine any modifications, if any, to be made in the interest in allowing me to perform my duties in a safely.
I certify that I have answered all questions truly and fully.
I am not aware of any health reason that would or may affect my working capability.