Application for Employment

Thank you for choosing D and R Homecare Staffing, LLC.

We look forward to working together with you.

D and R Homecare Staffing, LLC is very flexible with many opportunities to offer you and we work hard to get you the hours you desire at the facilities you request. In addition to completing the hiring packet we will need copies of the following forms to complete your employee file:

· Driver’s License and SS Card (for I-9)

· Current License (if applicable)

· Current BLS

· Current ACLS/PALS/NRP (If applicable)

· Copy of Immunization record (Proof of MMR)

· Copy of TB (PPD Skin test) within one year

· Copy of COVID-19 Vaccination Card / Negative Test Results

All documents can be mailed here:

The application process can seem overwhelming at first, but all of the documents required are the same that are needed for hospital employment. We have built a good reputation for our meticulous record keeping and meeting stringent nurse hiring requirements which has allowed us to gain more hospital contracts and offer more shifts with fewer cancellations.

We are honored that you have decided to join our team and allowing us to represent you in the healthcare industry.

If you have any questions, please feel free to contact our office at 248, 259 8426.


D and R Homecare Staffing Team

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Present Address:

Employment Desired:


List below three persons not related to you who have knowledge of your work performance within the last three years. If this does not apply to you, then provide three school or personal references that are not related to you. Provide phone number and address of these individuals.

Education and Training

Employment History:

License Information

(Do not identify convictions for marijuana-related offenses that are more than two years old; or convictions for which the criminal record has been expunged, sealed or eradicated by the court; or, misdemeanor convictions for which any probation has been completed and the case dismissed by the court.)

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