Caregiver Application

Join a licensed nurse registry serving Miami-Dade and Monroe County. Three short steps, about 5 minutes.

Prefer to skip the form?

Message us on WhatsApp and a real coordinator will help you apply — no typing required. Chat with us now

About You

Let's start with how to reach you.

Thanks for wanting to work with us. This takes about 5 minutes. If you have your documents handy you can upload them at the end, or simply bring them to your interview.

First name Please enter your first name.

Last name Please enter your last name.

Email Please enter a valid email address.

Mobile phone Please enter a valid phone number.

City you live in Please enter your city.

ZIP code Please enter a 5-digit ZIP.

Preferred language Please select a language.

Other languages you speak

Work authorization

US Citizen Permanent Resident Work Visa / EAD Other

Please select your work authorization.

Documents & Signature

Upload what you have now so we can start your file right away. Clear photos or scans work best — JPG, PNG, or PDF, max 10 MB each. Uploads are optional; anything missing can be brought to your interview.

Prefer to hand in your documents in person?

No problem. Bring the originals to your intake interview and we will copy them for you. Please bring the originals to the interview either way.

1Required documents

Upload each one you already have. Leave the rest blank.

HHA certification or CNA license LPN or RN license if you're applying as a nurse.

Resume Updated within the last 2 years. English only.

Two professional reference letters You can select both files at once.

Highest educational degree Diploma or certificate.

Car insurance No car? Upload a short signed letter explaining how you get to work.

Physical exam with TB skin test Within the last 12 months.

Liability / malpractice insurance Your current policy page.

Driver's license or Florida ID Front and back, in color. You can select both at once.

Brought in person only, never through this website:

Social Security card (front & back, signed, in color)
Legal status documents, if applicable (front & back, in color)
FDLE Level II background screening (AHCA)

For your protection, we never ask for these online.

2In-service trainings

These certificates are part of your file. If you already have them, bring them. If not, we'll tell you how to complete them.

Abuse, Neglect & Exploitation
Alzheimer's Disease
Bloodborne Pathogens
CPR & First AidIn person only. American Heart Association, American Safety & Health Institute, or American Red Cross.
Domestic Violence
HIPAA
HIV / AIDS
Infection Control
Medical Error Prevention
Medication Administration
OSHA

All required documents must be turned in within 15 days after your first day of work.

3Signature

By typing my full legal name below, I certify that:

All information I've provided in this application is true and complete to the best of my knowledge.
I authorize Our Services 4 You to conduct a Level 2 background screening as required by Florida law.
I understand that caregivers referred through the registry work as independent contractors, not employees, and I agree to those terms if placed.
Any false statement may result in disqualification or removal from the registry.

Type your full legal name as signature Must match the first + last name you entered in Step 1. Signature must match your name from Step 1.

Today's date Please enter today's date.