Caregiver Registration

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Thank you for your interest in becoming part of our database at Prime Caregivers. Please complete and submit this application so we can begin the process of matching you with a client.

Prime Caregivers is a Caregiving Referral agency. Contact will be for referral only. We do not directly employ any Caregivers.

Emergency Contact information:

List 2 individuals we can contact in case of an emergency
e.g., Spouse, Brother, Friend, etc.

Work Preferences

Day (5am-5pm), Night (5pm- 5am),

Client Preferences

Additional Information

For example: Sewing, beautician, barbering, gardening, cooking, singing, etc.

Driving and areas of work

Please select the areas where you are willing to work:
Driving for the client usually increases hourly/live in pay


Provide copies of certifications during the hiring process.

Training and Education

Training and Education

Work Experience

Please list your most recent employers first

Work Experience 2

Prime Caregivers is a Referral Agency. Prime Caregivers does not employ any Caregivers. All information obtained is stored in our secure database and will be matched to clients with no discrimination.