Name: Signal Health Group
Address: 10475 Crosspoint Blvd, Indianapolis, IN, 46256, US
Telephone: 800-953-6183
Price range: $$

SCREENING FORM FOR POTENTIAL EMPLOYEES
Date:	Call completed by:
Application sent to:
Applicant’s Phone Number
Name:
Address:
City/State/Zip:
1 How did you hear about us?
2 What type of vehicle do you drive?
3 What part of town do you live in?
4 Have you done before?
5 Tell me a little about your experience
6 Are you looking for full or part time work?
6a What hours are you available?
7 How comfortable are you with doing hand on care?
8 Can you work weekends?
9 How about overnight and 24 hour shifts
For internal use: How would you rate this person’s communication skills?
For internal use: Application not sent because:

SCREENING FORM FOR POTENTIAL EMPLOYEES