Join Our Team · Medicaid Accepted Agency

Join Our Care Team

We are looking for compassionate, dependable individuals who want to make a real difference in the lives of our clients.

Personal Information

Full Name *

Phone Number *

Email Address *

Full Address *

Experience & Skills

Work Experience (Years in caregiving, previous employers) *

Certifications & Skills (CNA, CPR, First Aid, etc.)

Availability *

Select all that apply.

Full-timePart-timeWeekends Only

Required Documents

Upload clear photos or PDFs of your documents below (max 8MB each). They're stored securely and only visible to our staff.

Government-Issued ID — Form 1 *

Driver's License, Passport, State ID, etc.

Government-Issued ID — Form 2 *

A second, different ID — Social Security Card, Birth Certificate, Passport, etc.

Most Recent TB Test (Optional)

If you have a TB test from the last 12 months, note it here or email a copy. If not, no worries — we can help arrange one before your start date.

Prior Job References

List three previous employers who can speak to your caregiving or work experience. All three are required.

Prior Employer 1 (Required)

Employer / Company Name *

Your Job Title *

Supervisor / Contact Name *

Dates of Employment *

Phone *

Email *

Prior Employer 2 (Required)

Employer / Company Name *

Your Job Title *

Supervisor / Contact Name *

Dates of Employment *

Phone *

Email *

Prior Employer 3 (Required)

Employer / Company Name *

Your Job Title *

Supervisor / Contact Name *

Dates of Employment *

Phone *

Email *

Personal References

List two people who know you personally and can speak to your character. Do not list family members.

Personal Reference 1 (Required)

Full Name *

Relationship *

Phone *

Email *

Personal Reference 2 (Required)

Full Name *

Relationship *

Phone *

Email *

Final Details

Why do you want to work with Committed Companions? *

Background Check Consent * — I understand that employment is contingent upon the successful completion of a criminal background check and reference verifications.