Reference Request

REFERENCE REQUEST

Please complete our standard reference request form

REFERENCE REQUEST

As part of our recruitment process a candidate has given your name as a referee. To enable us to standardise references we would gratefully request that you complete the form.

The information submitted will be held on the employment record of the individual for the period that they are employed with ICRIT Healthcare or any of our companies.

Your Name*

Position*

Referee Email*

Company*

Applicant Name*

Applicants Job Tile Whilst Employed*

Company or Place of Employment Address*

Still employed?*

Start Date*

Leaving Date (Leave Blank If Still Employed)

Employment Performance

Please now rate specific areas of this person's work performance.

Reliability & Punctuality*

Honesty & Integrity*

Standard of Work*

Ability to work with others*

Ability to follow instructions*

Is this person part of any current disciplinary procedure or investigation?

Subject to company policy and position availability would you re-employ this individual?*

If not, why not?

Do you have any other comments that might assist us when assigning work or employing the applicant?

Do you have or know of any reason why this applicant would not be suitable to work or have contact with vulnerable people, including children, within a care provider organisation?*

Thank you

Thank you for taking the time to complete the form your assistance is very much appreciated.

You will receive an email confirming the details submitted.

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REFERENCE REQUEST

ICRIT Healthcare

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