Interested in working with Sina Caregivers in Connecticut?

Please complete the form below and let us know a few more details about yourself

1. Applicant Information

Position you are applying for

Personal Details

First name

Last name

Email

Phone

Address

How Did You Hear About Us

License Type

2. Caregiver Experience

Do you have Home care experience?

Yes

No

Are you available for Live-in care?

Yes

No

Are you currently living and caring for someone over 65 and older?

Yes

No

3. Qualification & Skills

Do you have a driver's license?

Yes

No

Languages

Primary

Secondary

3. Logistics & Availability

Timetable

4. SMS Notifications

Would you like to receive sms messages?

I opt-in to receive SMS messages

I opt-out to receive SMS messages

By clicking ‘I Opt In’ and submitting this form, you consent to receive SMS messages from Sina Caregiver at (203) 590-1783 about Account Notifications, Customer Care, or Marketing. Message frequency may vary, and standard messaging and data rates may apply. Reply STOP to unsubscribe or HELP for assistance. For more details, see our Terms and Conditions and Privacy Policy.