Apply for Job - Sycamore Healthcare Solutions Limited

Join Our Team

At Sycamore Healthcare Solutions, we’re always seeking compassionate, qualified care professionals to help us deliver excellence. Submit your profile today — whether you’re a nurse, support worker or allied health professional — and we’ll match you with fulfilling roles that align with your skills, values, and ambitions.

Application Form

1. Personal Information

Photo (passport-style, optional)

Title (Mr/Mrs/Ms/Dr/Other)

First / Middle Name(s)

Surname

Date of Birth (DD/MM/YYYY)

National Insurance Number

DBS Certificate Number

Home Phone

Mobile Phone

Email Address

Postcode

County / State

Address (Line 1)

Address (Line 2)

Town / City

Notes (Office Use Only)

2. Passport / Visa Details

Passport Nationality

Passport Expiry Date

Type of Visa / Work Permit Held

Visa / Work Permit Expiry Date

Visa Restrictions (if applicable)

3. Position Applied For

Select all relevant roles:

CareworkHealthcare ProfessionalSupport WorkerQualified NurseHospital HCAMidwife / Health VisitorHealth Care AssistantSocial WorkerRadiographer / SonographerNon-Medical / Non-ClinicalOther

If Other, please specify

4. Qualifications

List all qualifications (school/college/university, address, dates, qualification gained)

5. Employment History

(From school leaving age in reverse order, including gaps)

Employer 1 (Most Recent)

From (MM/YY)

To (MM/YY)

Employer Name & Address (incl. Tel)

Job Title & Specialities

Reason for Leaving

Employer 2

From (MM/YY)

To (MM/YY)

Employer Name & Address (incl. Tel)

Job Title & Specialities

Reason for Leaving

Employer 3

From (MM/YY)

To (MM/YY)

Employer Name & Address (incl. Tel)

Job Title & Specialities

Reason for Leaving

6. Professional References

1st Reference

Name of Referee

Position Held

Business Address

Postcode

Referee’s Email

Telephone No.

2nd Reference

Name of Referee

Position Held

Business Address

Postcode

Referee’s Email

Telephone No.

7. Emergency Contact / Next of Kin

First Name

Surname

Tel No.

Mobile No.

Emergency Contact No.

Relationship to You

Address

Postcode

8. Confidentiality Agreement

I understand that any information regarding patients or clients is confidential and must not be disclosed to anyone outside the organization. Breach of confidentiality is considered serious misconduct.

9. Rehabilitation of Offenders Act 1974

Do you have any convictions, cautions, reprimands, or final warnings not “protected”?

YesNo

If yes, provide details

10. DBS / References Consent

Did you hold a DBS issued in the last 12 months?

YesNo

DBS Number

Issue Date

Is your DBS registered with the Update Service?

YesNo

I give permission for Sycamore Healthcare Solutions to obtain references covering the last 3 years.

11. Declaration

I declare that the information provided is complete and accurate to the best of my knowledge. Providing false information may disqualify me from registration, with possible referral to regulatory bodies. I consent to audit assessment of my file by relevant third parties.

Name

Date

Signature (type your full name)