Caregiver Enrollment | CareMatch Pros

CareMatch Prosby AMS Caregiver network

1 Contact and service area

First nameLast nameEmailTelephoneStateCityZIP codeTravel radius

2 Role, license and credentialsRoles sought Select all that apply

Professional license, certification or registry

Required when applicable to the position selected. Companions and sitters may select “Not applicable.”

Credential typeLicense, certification or registry numberIssuing state or authorityExpiration date If applicableCredential statusCompact or multistate license?

Years of caregiving experienceWork preference

Other credentials and certificationsCaregiving experience and populations servedProfessional references

3 Age-specific care and skills

For each age group, indicate whether you have relevant training or hands-on experience.

Neonatal carePediatric careAdolescent careAdult careGeriatric care

Skills assessment Select all that you can perform safely and within your permitted scopeOther skills

4 Availability and trainingCurrent availability

Reliable transportation?Training and CEU interest

Languages spoken

I confirm that I have received education on applicable OSHA and safety procedures, including infection control, universal precautions, bloodborne pathogens, fire prevention, body mechanics, and chemical hazards.

5 Screening and referral

Have you been convicted of a felony?How did you hear about us?Recruiter or referral name If applicable

A disclosure does not automatically disqualify an applicant. Any screening decision will be evaluated under applicable federal, state, and local law and the participating organization’s documented criteria.

6 Authorization

I authorize CareMatch Pros to contact the professional references I provide.I authorize verification of credentials and understand additional written authorization will be required before any third-party background report is obtained.I authorize CareMatch Pros to share my approved professional profile with selected participating businesses.I certify that the information provided is accurate and understand enrollment does not guarantee employment or placement.