Sub-Contractor Hiring Form

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Sub-Contractor Hiring Form
1.Personal Information
Name:
Name:
First Name
Last Name
2. Position Applied For (Select one)

3.Certifications and Licenses

4.Availability

5.Insurance and Compliance

Do you have liability insurance?
Are you covered by worker’s compensation?
Are you compliant with local/state regulations?

6.References

Reference 1: 

Reference 2: 

7. Agreement

I agree to comply with Wow Deluxe Care Inc. policies and procedures as a sub-contractor.

     Please return the completed form along with copies of your certifications and proof of insurance for processing.

About Us

At Maxcare, we are dedicated to delivering exceptional healthcare with compassion, innovation, and integrity. For over 20 years, we have been a offering comprehensive medical services in USA

Contact Info

231 Utah City Centre, Utah, USA