Fields marked with    * are mandatory

Application




Availability Agreement

I understand Preferred Home Care may offer short hour assignments and will make every effort to offer additional short hour cases to provide paraprofessionals/health aides with additional hours of work at the paraprofessionals/health aides request. In order for paraprofessionals/health aides to remain in an active status, employed paraprofessionals/health aides must work/provide services to students continuously during employment. Paraprofessionals/Health Aides that do not provide services for a period of 120 days may be terminated. I further understand that declining/refusing more than three cases in a 30 day period may result in discharge. It is the responsibility of the paraprofessional/health aide to communicate with the agency regarding any changes to availability and to request cases to ensure compliance. I am aware that I cannot and will not work with any other organizations during the hours that I am assigned to provide paraprofessional/health aide services to a student of Preferred Home Care of NY.

* I have read, understand, and agree to abide by the complete agreement.


By signing below I acknowledge that all the information provided above is true and accurate. I further acknowledge my understanding of the terms and conditions listed above.

Please sign with-in the signature pad highlighted in yellow below.

Upload Documents

Please drag these documents if you have them available. (optional) maximum file size limit for uploads: 10mb