Application Form

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    Personal Information

    Title (required)

    First Name (required)

    Last Name (required)

    Email Address (required)

    Contact Number (required)

    Address Line 1 (required)

    Address Line 2 (required)

    Postcode (required)

    Country (required)


    Where did you hear about this role? (required)

    Are you already authorised to work in the UK e.g. by being a UK/EU citizen, or by holding a valid permit to work? (required)

    Salary Expectations:


    Rehabilitation of Offenders Act 1974

    Because of the nature of the work for which you are applying, the post is exempt from the provisions of Section 4 (2) of the above Act and all applicants who are offered employment will be subject to a Disclosure & Barring Service check before the appointment is confirmed.

    The amendments to the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are 'protected' and are not subject to disclosure to employers, and cannot be taken into account. Guidance and criteria on the filtering of these cautions and convictions can be found at the Disclosure and Barring Service website.

    Having a criminal record will not necessarily prevent you from working with us; this will depend on the nature of the position and circumstances and background of your offence.

    Do you have any unspent convictions, cautions, reprimands or warnings? (required)

    Independent Safeguarding Authority

    You are also required to declare if your name is included on the register maintained by the Independent Safeguarding Authority (previously, The Protection of Children Act List, the DfES List 99 and the Protection of Vulnerable Adults List).

    Has your name been added to the Independent Safeguarding Authority Register? (required)

    Are you applying for a professional medical or clinical position? (required)

    Professional Conduct

    Have you been subject to any investigation into your professional conduct by any licensing, regulatory or professional body in the UK or any other country where the outcome was adverse? (required)

    Have you been removed, contingently removed or suspended from, refused admission to, or conditionally included in any list or equivalent list kept by a PCT, NHS Trust or equivalent professional or regulatory body, or are currently suspended from such a list in the UK or any other country? (required)

    Are you currently the subject of any investigation by any professional organisation in the UK or any other country, which might lead to your removal from any of their lists?:

    Do you agree to inform Verity Healthcare immediately if any investigation should be initiated that may have a bearing on your suitability for this post?: (required)

    By submitting this application I am agreeing to the following statement:

    I confirm that the information given on this form is, to the best of my knowledge and belief, true and complete. I understand that Verity Healthcare is not legally allowed to employ persons to work with vulnerable adults or children who are deemed ‘not fit’. If any of the information I have given is found to be false or misleading, Verity Healthcare can withdraw their offer of employment to me, or cancel their agreement with me. I understand that if this is discovered at a later date, I may be dismissed.

    I agree on Verity Healthcare to use my contact details to communicate directly with myself regarding this application, to inform me of future relevant vacancies and to send marketing communications.


    Attach CV - Applying via a mobile or smartphone? If you are having trouble uploading your CV from your phone, we suggest saving your application and adding any attachments from a computer.


    Verity Healthcare is committed to a policy of equality in all employment practices. To assist in the effective implementation of this policy, applicants are asked to provide the information below. This information is treated in the strictest confidence and is used purely for monitoring purposes, not for selection.

    Do you want to complete the equality questionnaire? (required)

    Data Privacy Statement

    By selecting ”I agree” you confirm that you have read, understand and consent to the Data Privacy Statement (click to read the whole statement).

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