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Welcome New Members

If requested, please be prepared to provide copies of the following items:

Current resume
Professional license
Driver's license
Auto insurance
CPR card
Social Security Card
Proof of 1 hour HIV CEU
Proof of 2 hour "Alzheimer's and Related Dementias" CEUs
DOEA certificate for new Alzheimer training video.
If applicable: CNA/HHA certificate or training documents
Any other certificates such as wound certifications, IV certifications, etc.

Please complete each section.

General Application Reference Checks (2)Annual TB Questionnaire Confidentiality Statement Hepatitis B Declination Covid Questionnaire In-Service Agreement Conflict of Interest Statement Employee Handbook

Downloads

Please download and complete each form. You may also obtain copies from your nearest TEHC office.

AHCA Privacy Policy Ackowledgment Form (pdf)

Alzheimers Disease Handout (pdf)

Attestation of Good Moral Character (pdf)

Direct Deposit Form (pdf)

Health Statement (pdf)

W4 2024 (pdf)

I-9 Employment Eligibility Verification (pdf)

Mandatory 1-Hour DOEA Alzheimer's Training (If Needed)

Watch the video and complete the form at the end.

Dept of Eleder Affairs 1 hr Training Video

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