Reference Form Referee DetailsName *Contact NumberJob TitleCompanyIn what capacity did you know the applicant?APPLICANT DETAILSFirst NameSurnameJob TitleCompanyDates Employed FromDates Employed ToReason for leaving0 / 200Would you re-employ this person?0 / 200If no, please provide detailsSECTION 1HOW WOULD YOU ASSESS THE FOLLOWING? Please tick relevant boxes (Excellent, Good, Poor)Ability to follow care plansExcellentGoodAveragePoorReliability, time keeping, attendanceExcellentGoodAveragePoorCharacterExcellentGoodAveragePoorAttitudeExcellentGoodAveragePoorAbility to ensure dignity is upheldExcellentGoodAveragePoorCommunicationExcellentGoodAveragePoorRelationships with colleaguesExcellentGoodAveragePoorAbility to work under own initiativeExcellentGoodAveragePoorSECTION 2Please answer the following questionsHas the applicant been subject to any disciplinary action?YesNoIf yes, please provide details:Are you aware of the applicant's involvement in any safeguarding investigations? (previous or current)YesNoIf yes, please provide details:Are you aware of any reasons why the applicant should not be employed to work with children or vulnerable people?YesNoIf yes, please provide details:To the best of your knowledge, has the applicant been convicted or cautioned of a criminal offence?YesNoIf yes, please provide details:*Due to the nature of care work, all spent convictions must be disclosed (Rehabilitation of offenders act 1974)Additional comments:0 / 250PLEASE CONFIRMI can confirm that all the details provided are accurate at the time that this reference was completed. I understand that the applicant has the legal right to request a copy of their reference.Full Name *Position *Upload Signature *Choose FileNo file chosenDelete uploaded fileDate *We always ensure that our candidates undergo our rigorous recruitment process prior to any work being offered to them. Therefore, the more rapid the response is - the faster we can assess the candidate and allow them to start working.SUBMIT FORM