Join our care team

First name

Surname

Email

Contact number

Do you have the right to work in the UK?
—Please choose an option—YesNo

Do you hold a British Passport?
—Please choose an option—YesNo

Do you hold a professional carer insurance certificate?
—Please choose an option—YesNo

Do you hold a full UK driving licence?
—Please choose an option—YesNo

Do you have access to your own vehicle?
—Please choose an option—YesNo

Are you happy to work outside of London?
—Please choose an option—YesNo

Do you have any medical conditions that could affect your ability or availability to work?
—Please choose an option—YesNo

Do you have any allergies – pets/food etc.?
—Please choose an option—YesNo

If yes, please provide details:

Cocoon only provides live-in care. Are you willing to work away from home in a live-in role?
—Please choose an option—YesNo

What is the maximum number of weeks you will work for a booking?

When would you be available to start?

Do you have any holiday booked?
—Please choose an option—YesNo

If yes, please provide dates:

How many years of care experience do you have?
—Please choose an option—NoneLess than 1 year1-3 years3-5 years5+ years

Do you have an Enhanced DBS certificate no more than one year old?
—Please choose an option—YesNoIn progress

Are you on the DBS Update Service?
—Please choose an option—YesNo

Do you have any relevant qualifications (e.g., NVQ Level 2 or 3 in Health & Social Care)?
—Please choose an option—YesNo

If yes, please provide details:

Referee 1:
Name

Relationship to you

Organisation

Contact details

Referee 2:
Name

Relationship to you

Organisation

Contact details