WARNING: It is an offence under The Fraud Act 2006 to deliberately make, or cause to make, a false or misleading statement, or
conceal circumstances in relation to an application.
Please read the following carefully before signing:
- I declare that the information I have supplied in this application form is complete, truthful and correct in every detail.
- I have read the information in the Induction Handbook and the Terms of Engagement as applicable to me (in accordance with my tax status is
Section 13 above) and I accept the Terms of Engagement.
- I acknowledge that if my tax status is as a limited company/PSC by signing this application for I will be signing on behalf of the limited company/PSC and I confirm that I am authorised to do so.
- I achnowledge and agree that by commencing an assignment (as defined in the Terms of Engagement) I will be confirming that I am willing to work in the position set out in the relevant Confirmation of Assignment Form and I acknowledge that the Terms of Engagement will be deemed to have been accepted by me upon my commencing an assignment.
- I acknowledge and agree that if my tax status at Section 13 changes I will notify CarePlus Healthcare and I will refer to the Induction Handbook for the
Terms of Engagement applicable to my new tax status. I agree that by commencing an assignment following my change of tax status I will be deemed
to have accepted the Terms of Engagement relevant to my new tax status upon my commencing the assignment.
- I understand that my selection against Access to Medical records at Section 16 will give/refuse permission for CarePlus Healthcare to have access to my
medical records pertinent to my immunisation and blood test history.
- I understand that it is my responsibility to undergo an annual appraisal and to supply CarePlus Healthcare with relevant information in relation to this.
- I understand that it is my sole responsibility to update CarePlus Healthcare in the event of any disciplinary action, investigation or changes to my professional registration.
- I acknowledge that it is my sole responsibility to update CarePlus Healthcare in the event of any disciplinary action, investigation or changes to my
professional registration.
- I understand CarePlus Healthcare nay collect, use and disclose my personal information to the authority, or any person, firm or organisation duly authorised on the authorities behalf for the purpose of Audit undertaken within the Framework agreements or otherwise in accordance with the Data
Protection Act 1998 and I consent to the provisions of paragraph 1.5 of the Induction Handbook relating to use of my personal data.
- I agree that if I have given any false or misleading information, or do not give relevant information (including any change to the information I have
previously provided) to CarePlus Healthcare now or during the course of an assignment, this may result in the termination of the assignment with
immediate effect.
If any information supplied is later found to be false or misleading then CarePlus Healthcare may terminate employment with immediate
effect and refer the matter to the relevant regulatory and or professional bodies.
All CarePlus Healthcare related companies (“CarePlus Healthcare”) including CarePlus Healthcare Group Ltd, Recruitment Express Ltd
(trading as The Locum Consultancy), and Group 24 Ltd are each separate legal entities but are related through common ownership.
Each specialises in temporary recruitment.
By signing this declaration, you agree to the Terms of Engagement for the purpose of temporary recruitment and the declaration laid
out above for CarePlus Healthcare. This enables you to have access to work through all CarePlus Healthcare related companies.