Indiana Health Care Services
(800) 260-6145
Franchise
(800) 953-6183
info@signalhg.com
info@signalhg.com
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HHA/PCA/HMK Interview
Home
HHA/PCA/HMK Interview
Date
HHA/PCA/HMK Interview Form
Applicant Name:
Applying For:
Full Time
Part Time
Per Diem
Discipline / Department
Tell me a little about yourself ?
Why do you want to work in Home Health Care ?
How would you handle the stress associated with Home Health?
Why do you want this particular job ?
How do you react to change ?
What areas do you feel you would need/like improvement in ?
Describe your organizational skills/time management skills ?
Why are you available for this job?
What is your definition of company loyalty?
How can you be of value to this Agency?
What are your career objectives ?
Where do you want to be in the next five (5) years ?
Applicant Name:
What would you say your clinical strengths are ?
Level of experience? / List Questions Here
Yes
No
Some/little Experience
What areas do you think you need improvement in ?
Describe a difficult/stressful situation you have had in Home Health Care and how did you resolve it?
Describe/Rate your interpersonal skills with:
Peers ?
Doctors ?
Patients ?
Immediate Supervisor?
( IF RN ) how do you describe your communication skills with other disciplines:
LVNs / LPNs ?
Home Health Aides ?
Therapists ?
Describe your work ethic ?
On-call Service Availability ?
Are you familiar with Medicare requirements relative to home care?
Are there any other Home Health Care programs that you familiar with ?
Applicant Name:
FINISH INTERVIEW PROCESS
Go over information about the Agency.
Explanation of benefits after 90 day probationary period.
Interested in this position ?
When to expect a call back from Agency
Go over Salary. / What are your salary requirements ?
OTHER ISSUES OR SPECIAL SITUATIONS THAT WERE DISCUSSED IN THIS INTERVIEW PROCESS?
COMMENTS:
Completed Interview:
Date
English
English
Spanish