One of your references must be your current or most recent employer.
PLEASE NOTE: WE ONLY ACCEPT COMPANY EMAIL ADDRESSES NOT YAHOO, GMAIL, HOTMAIL ETC.
I am aware of The Working Time Regulations, 1998, and understand their implications with reference to my Terms & Conditions of Employment. MM Care Services time-keeping Records will confirm my hours worked on a weekly basis. Where these records confirm that I have worked in excess of 48 hours per week I agree that this 48-hour week limit under The Working Time Regulations, 1998, shall not apply to me.
I understand that I may agree to opt back into the 48-hour week limit at any time, giving the appropriate two months’ notice.
Please read all the information provided in this part and respond by ticking the box at the end.
There is a medical questionnaire to complete separately to obtain your certificate of fitness.
If you have any doubts about your medical fitness to perform the job you are applying for, please contact MM CARE SERVICES for further discussion.
Data Protection Act 1998/Freedom of Information Act 2000/ confidentiality
That MM Care Services will treat the information you provide in a strictly confidential manner, and it will be held in accordance with the principles of medical ethics and relevant legislation
Equality Act 2010
The information you will provide will enable MM CARE SERVICES to assess your medical fitness against the specific requirements of the placements you will be considered for. If you have a disability or impairment, the information you give us will help us to ensure right placement safe for you and for the patients you will be looking after. The information you give us will also provide baseline data for any future health assessment(s) that may be made during the time you work with us.
What happens to the information provided?
MM CARE SERVICES will use the information you will provide to complete their assessment of whether you are medically fit for the work available for you. The form will be retained confidentially by MM CARE SERVICES
Conditions for applicants involved in the care of patients
You must inform the MM Care Services if you have ever tested positive for any transmissible blood borne virus infection (e.g. Hepatitis B Hepatitis C, or HIV) or you have any other illness may affect the care of patients. Furthermore, during your employment you must inform the MM CARE SERVICES if, at any time you are diagnosed as having, or suspect that you may have contracted any blood borne disease, or you have any other illness that may affect the care of patients. If aspects of your work may involve a risk of transmission to patients, you must refrain from such work until the risk has been assessed and any necessary measures to prevent transmission have been agreed and implemented.
PLEASE NOTE: should the employment involve participation in surgical or exposure prone procedures you will not be passed fit to commence work until: (1) MM Care Services has obtained satisfactory documentary evidence of your immunization status; (2) you have completed any tests necessary to comply with the Department of Health requirements; or (3) you have completed any tests necessary to comply with the relevant NHS Trust’s Infection Control Policy
I have completed my bank details and confirm they are complete and correct. I hereby understand that any incorrect or incomplete details can result in a delay of my payment.
I am aware that more detailed information on the Staff Handbook and Policy and procedures can be obtained directly from MM Care Services office
MM Care Services staff are committed to being an equal opportunities employer and we welcome applications from all sections of the community. We will ensure that all candidates for employment are treated fairly, and in order to monitor our responsibilities and to measure our progress towards widening diversity among our workforce, we would be grateful if you would answer the simple questions in the boxes below. The information you provide will remain anonymous and is for statistical monitoring purposes only. This form will be separated from your application upon your receipt and is not used as part of the applicant selection process.
I agree that MM Care Services retains the right to hold this application and any other data required to it and to pass on to any authorised third party the details held within, also to retain these details for as long as reasonably necessary in accordance the Data Protection Act 1988.
I have read the information provided on this form and I have answered all the questions honestly, accurately and in full.
I also understand that should I conceal relevant information or provide deliberately misleading information about my health either on this form or at a the health interview , my application may be withdrawn, or further placements with MM Care Services may be terminated.
Female candidates: if you are pregnant, or think you might be, you should inform the recruitment team as soon as possible before any job offer or during temporary or contract placements through MM Care Services. This is required in order that an appropriate risk assessment of your workplace and your employment may be performed as required by the Management of Health and Safety at W ork Regulations 1999.I understand that the information I provide may be released to my employer for the purpose of determining whether any adjustments are required or can be made if possible, and I consent to the release of such information.
To discuss any aspects of this process confidentially with MM Care Services contact us: 9 Tedworth Avenue, Stenson Fields, Derby, DE24 3BS , firstname.lastname@example.org
Occupational Health evidence required (For clinical staff only)
Training Evidence Required (for all)