Caregiver Registration

orange county caregivers

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.

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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

Certifications

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.