CRUZ Home Care

Independent Contractor Application / Aplicación de Contratista Independiente

Fill out this form. Fields marked with * are required.

Independent Contractor (1099)

All positions at CRUZ Home Care are Independent Contractor (1099) positions, not employee (W-2) positions. By submitting this application, you confirm that you understand and accept this working arrangement. You will be responsible for your own taxes, transportation expenses, and insurance coverage.

Todas las posiciones en CRUZ Home Care son de Contratista Independiente (1099), no de empleado (W-2). Al enviar esta aplicación, confirmas que entiendes y aceptas esta modalidad de trabajo. Serás responsable de tus propios impuestos, gastos de transporte y cobertura de seguro.

Personal information

Full name *

Date of birth

Email *

Phone *

Address

City

State

ZIP

Desired position

Position *

Preferred office *

Languages

Availability

Do you have a car?

Can you pass a background check?

Experience

Years of experience

Certifications / licenses

Describe your experience

HHA / CNA — Competency Test

¿Tienes certificación HHA o CNA vigente? / Do you have a current HHA or CNA certification?

Para trabajar como HHA o CNA con CRUZ Home Care necesitas certificación vigente o aprobar nuestro Competency Test(104 preguntas, 80% para aprobar, basado en FL Rule 59A-36).

To work as an HHA or CNA you need a current certification or pass our Competency Test (104 questions, 80% to pass, FL Rule 59A-36).

Solicito tomar el Competency Test. Entiendo que la administradora debe aprobar mi solicitud antes de que pueda tomar el examen, y recibiré un enlace por email. / I request to take the Competency Test. I understand an administrator must approve my request before I can take the exam, and I will receive a link by email.

Personal references

Two people who can give a reference for you.

Name

Relationship

Phone

Name

Relationship

Phone

Documents

PDF or image. Max 20MB per file. Only the CRUZ admin will see them.

Photo of your ID

Social Security card

Certifications (optional)

Additional notes

I understand and agree that this position is as an Independent Contractor (1099) and not as an employee. / Entiendo y acepto que esta posición es de Contratista Independiente (1099) y no de empleado.