• License Number 30211460
  • Call Us 561-495-7448
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AmeriHome Health Care
  • About
    • Company
    • Team
  • Services
    • Insurance Accepted
    • Home Health Aide (CNA/HHA)
    • Special Needs and Respite Care
    • Registered Nurse (RN)
    • Licensed Practical Nurse (LPN)
    • Companion Services
  • Careers
  • Testimonials
  • Pricing
AmeriHome Health Care
  • About
    • Company
    • Team
  • Services
    • Insurance Accepted
    • Home Health Aide (CNA/HHA)
    • Special Needs and Respite Care
    • Registered Nurse (RN)
    • Licensed Practical Nurse (LPN)
    • Companion Services
  • Careers
  • Testimonials
  • Pricing

Independent Contractor Registration Request

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Step 1 of 4

25%
  • (Be Specific)
  • (Be Specific)
  • e.g 05/11/2015 - 17/18/2016
  • High School

  • College/Vocational School

  • Type of Degree

  • WORK HISTORY:

    List present and past work related to home care, beginning with the most recent home care services you provided.

  • Work 1

  • Work 2

  • Work 3

  • Home Health Certificate

  • CNA Certificate

  • Upload your HIV/AIDS ins-service certificate here
  • Upload your Domestic Violence in-service certificate here
  • OSHA in-service certificate

  • (EXPIRES EVERY TWO YEARS)
  • Upload your Alzheimer’s Disease in-service certificate here
  • Upload your Assisting with self-medication in-service certificate here
  • Physical

  • (not older than 6 months and must state “Free from communicable disease” or (no apparent signs or symptoms of communicable disease) NOT FROM A CHIROPRATOR
  • Valid C.P.R. card or Certificate dates

  • Liability Insurance

    A Level II Background screening and clearance from AHCA prior to being placed on an assignment
  • For 1 year
  • (required for all HHA’s)
  • Document Upload

  • Drop files here or
  • Please upload the document on the list below

    • Two employment references with a valid phone number and complete address
    • Non-Expired Driver’s License
    • Valid Auto Insurance
    • Social Security Card, must be original
    • Original Non-Expired Resident Alien Card or employment Authorization if you are not an American citizen. If you are US citizen you must provide proof via (Passport, Voter’s Registration or Birth Cert.)

We do whatever it takes to bring
you peace of mind

  • Request a callback
  • 24/7 service available 561-495-7448
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Office

9045 La Fontana Blvd, Suite 231
Boca Raton, FL. 33434
561-495-7448

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Services

  • Home Health Aide (CNA/HHA)
  • Special Needs and Respite Care
  • Registered Nurse (RN)
  • Companion Services
  • Licensed Practical Nurse (LPN)

Company

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  • About Us
  • Testimonials
  • Caregivers
  • Contact us
© 2020-2021 AmeriHome Health Care | Designed by: Crazy Fox Digital
  • Home
  • About
    • Company
    • Team
  • Services
    • Insurance Accepted
    • Home Health Aide (CNA/HHA)
    • Special Needs and Respite Care
    • Registered Nurse (RN)
    • Companion Services
    • Licensed Practical Nurse (LPN)
  • Testimonials
  • Pricing
  • Contact us
  • Apply Today