Application Form

Fill the form below to join Westhub Healthcare armies of skilled nursing and Non-Nursing Professionals

First Name *

Home Address *

Last Name *

Position Applied for *

M.I

Date Available *

Phone Number *

Desired Salary/Hour *

Email *

Are you a citizen of the United States? *

Have you ever been convicted of a felony? *

If no, are you authorized to work in the U.S.? *

If yes, explain

Social Security/TIN No *

Have you ever worked for this company? *

Date of Birth *

If yes when?

Education

Education 1

School Name *

Address *

Degree *

From *

To *

Did you Graduate? *

Education 2

School Name *

Address *

Degree *

From *

To *

Did you Graduate? *

Military Service

Branch

Rank at Discharge

From

Type of Discharge

Previous Employment 1

Company *

Phone Number *

Address *

Supervisor *

Job Title *

Responsibilities *

From *

To *

Reason for Leaving *

May we contact your previous supervisor for a reference? *

Previous Employment 2

Company *

Phone Number *

Address *

Supervisor *

Job Title *

Responsibilities *

From *

To *

Reason for Leaving *

May we contact your previous supervisor for a reference? *

References 1

Reference Full Name *

Relationship *

Company *

Phone Number *

Address *

References 2

Reference Full Name *

Relationship *

Company *

Phone Number *

Address *

Upload Resume and Supporting Documents *

Drag and drop file here Or click to browse Upload Files

Maximum 3 files. Maximum file size: 20MB per file. PDF, DOC, DOCX, JPG, PNG, and WEBP are accepted.

Date *

Signature *

Drag and drop file here to sign Or click to browse Upload Files

By signing this document with an electronic signature, I agree that such signature will be as valid as handwritten signatures to the extent allowed by local law.

Disclaimers

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Download Documents

Alternatively download the documents below and submit to appropriate authority

Employment Application Form

Attestation to Guidelines for Nurses Working in Home Care

Conflict of Interest Statement

Employee HandBook

Employer & Employee Agreement

Request or Decline a Hepatitis B Vaccine

About Us

WestHub Healthcare Illinois State licensed, highly professional and Community Health Accreditation Partner (CHAP) certified Home Healthcare Agency with an excellent track record, offering In-Home Care and Home Nursing Services aimed at promoting the health and wellbeing of our clients of all ages and in particular our senior citizens.

At SHHCS we provide top-notch healthcare services with the help of our well-trained professional caregivers equipped with excellent professional skills and knowledge which makes our services stand out the best amongst the best. We strongly believe in continuous improvement; hence we seek to continually develop the most creative, innovative, and personalized homecare experiences for our clients and patients.

Join Us Today

Our Vision

To be the most trusted partner in home healthcare, setting the standard for excellence where every individual can lead a dignified, healthy, and independent life in the comfort of their own home.

Our Mission

To enhance the quality of life for our patients by providing professional, compassionate home healthcare that prioritizes physical health, emotional well-being, and genuine human connection.

Our Core
Values

Compassion First
Unwavering Integrity
Empowered Independence

Our Core Values

Compassion First

We approach every patient with empathy and kindness, treating them like a member of our own family to ensure they feel seen, heard, and valued.

Unwavering Integrity

We hold ourselves to the highest ethical standards, ensuring transparency, reliability, and clinical excellence in every interaction and treatment plan.

Empowered
Independence

We focus on supporting our patients' autonomy, providing the necessary care and tools that allow them to maintain their lifestyle and dignity at home.

Join Us Today

Application Form

Education

Education 1

Education 2

Military Service

Previous Employment 1

Previous Employment 2

References 1

References 2

Disclaimers

Download Documents

About Us

Our Vision

Our Mission

Our CoreValues

Our Core Values

Compassion First

Unwavering Integrity

EmpoweredIndependence

Book Appointment

Our Core
Values

Empowered
Independence