References - Please supply the names and work addresses of two clinical professional referees. One must be from your present or most recent employer and must be a senior grade to yourself and you must have worked for that person for a period of not less than three months duration.

COVID-19 & Flu Vaccination Declarations

Under the current guidelines, its recommended that every healthcare worker should have annual flu vaccination and also at-least 2 jabs of COVID-19 Vaccination to work within NHS.

Appraisal & Revalidation – (Nurses Only)

Professional Indemnity- (Nurses only) - We recommend that you take membership with a Medical Defence Organisation. If you are already a member, please provide details of your membership. Please forward copy with your application.

TUNIC DETAILS - Please tick your tunic & scrub size below in UK sizes, such as XS - XXL and ladies 8 – 24.

Declarations & Consent

To provide you with a compliant and efficient recruitment service, Caremint Recruitment Ltd. will need to undertake a range of checks which will involve accessing, processing, sharing and storing your personal data. We will also be required to share your personal data with our customers and their auditors to find you work, manage your placements and pay you as well as complying with our legal and contractual obligations.

I have read a copy of the Agency Worker Handbook which outlines the goals, policies, benefits and expectations of Caremint and its Clients, as well as my responsibilities as an Agency Worker. I have familiarised myself with the contents of this handbook. By my signature below, I acknowledge, understand, accept and agree to comply with the information contained in the Agency Worker Handbook provided to me by Caremint Recruitment Ltd.. I understand this handbook is not intended to cover every situation which may arise whilst on assignment, but is simply a general guide to the goals, policies, practices, benefits and expectations of Caremint.

I give permission for Caremint Recruitment Ltd. to send me marketing information. This may include details about vacancies and referral initiatives.

I give permission for Caremint Recruitment Ltd. to process my personal data to undertake a check of my identity and address to facilitate provision of job search and placement services.

I give permission for Caremint Recruitment Ltd. to process my personal data to undertake a check of my Professional Registration status (and if appropriate revalidation status) with the relevant Professional / Regulatory Body to facilitate provision of job search and placement services.

I give permission for Caremint Recruitment Ltd. to apply for an Enhanced DBS Check / verify my existing DBS certificate with the DBS Update Service or check my Disclosure Scotland membership when I register and on an ongoing basis as required to ensure compliance to facilitate provision of job search and placement services.

I give my permission for Caremint Recruitment Ltd. to process my personal data to check my right to work in the UK status with the UKBA / Home Office / Embassy to facilitate provision of job search and placement services.

I give my permission for Caremint Recruitment Ltd. to contact and share my personal data with any organisation where I have worked to verify my employment history or to obtain/validate a reference to facilitate provision of job search and placement services.

I give permission for Caremint Recruitment Ltd. to process my personal data to obtain a work health assessment or validate my occupational health and vaccination status to facilitate provision of job search and placement services.

I give permission for Caremint Recruitment Ltd. to process my personal data to verify my qualifications and training certificates to facilitate provision of job search and placement services.

I give permission for Caremint Recruitment Ltd. to process my personal data and sensitive personal data including bank details and NI number to facilitate payment into my account. I also give permission for such data to be shared with Caremint Recruitment Ltd.’s accountants and payroll/factoring suppliers.

I consent to all the data contained in my personal file being made available to external framework auditors, organisations where I have been placed and any prospective customers for audit, review and inspection purposes.

I give consent to Caremint Recruitment Ltd. to disclose any matter regarding pervious dismissals, warnings, complaints or professional body referrals to prospective employers.

I explicitly agree to abide by all Data Protection Laws with regard to all information regarding Caremint Recruitment Ltd. and its clients, candidates, patients and any other third party who I interact with during my registration or service with Caremint. I will not discuss information either verbally or in writing and if I am unsure about how to treat any information, I shall immediately contact Caremint for advice and clarification

For the purpose of the Working Time Regulations 1998 (as amended), I consent to work in excess of an average of 48 hours per week. I understand that I may withdraw this consent by giving Caremint Recruitment Ltd. not less than three months‟ notice. Your registration with Caremint can be terminated at any time following unsatisfactory work reports.

Caremint Recruitment Ltd. has a legal basis to process data and will do so in line with all Data Protection Laws. By signing this declaration, I agree to the above declarations and confirm I understand I have the right to: be informed of, withhold access, amend/rectify, erase and withdraw my data at any time.

Candidate Payment Method

*Subject to approval by Caremint prior to payment method being approved. Umbrella companies are required to comply with IR35 guidelines. Please check with your consultant if your chosen Umbrella company meets those requirements.

Please confirm you

Please provide your bank details if you wish to be paid via PAYE