Caregiver Agreement and Application

Thank you for your interest in Geri-Care Connection.  

The complete application can be accessed by clicking on the button on the bottom of this page.  Please fill out the entire application, including:

• 3 Professional work references, NOT family or friends. All references will be checked.  Letters of reference are acceptable with telephone numbers included.
• Telephone numbers of all references
• Read, date and sign the Caregiver Agreement and Application

  Also include copies of the following:   

1.  Valid Drivers License (we do not hire caregivers without a drivers license)        
2.  Social Security Card and Green Card (if applicable) needed for work authorization        
3.  CNA License (if you have one)       
4.  HHA Certificate (if you have one)       
5.  Nursing License (if you have one)

Please fill out the application COMPLETELY.  Failure to do so will delay processing. You will be contacted by Geri-Care regarding an interview when your application has been approved.  

If you have any question concerning the application process, please call our office at 203-972-7536  

Thank you,

Rinda Farnham Owner  

Caregiver Application