Call Us :  267-261-6609


Required Documents


  • Current PA Nursing License
  • Drivers License
  • Current CPR certification
  • Independent Contractor Agreement & Profile
  • Independent Contractor Waiver
  • Malpractice/Liability Insurance
  • ACT 168 form
  • ACT 24 Arrest and Conviction Report
  • Physical and PPD
  • FBI Finger printing for the Department of Education or Department of Public Welfare
  • Child Abuse Clearance
  • Criminal Record Check



THE FOLLOWING MUST be within one year of date of hire:
Physical form/PPD:
http://physicalform.pdf
​​
Criminal Record Check:
https://epatch.state.pa.us

FBI clearance – FBI fingerprinting:         
https://www.pa.cogentid.com/index_pdeNew.htm

Child abuse clearance link and form:
https://www.compass.state.pa.us/cwis/public/home​

Act 24- Arrest and Conviction form:
PDE-6004 Act 24


W-9 form:

http://www.irs.gov/pub/irs-pdf/fw9.pdf


ACT 168 Form(s):
(Required for present employer(s), as well as any/all previous employer(s) where Independent Contractor has had direct contact with children).