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Register with Bupa

Completing this form does not impose or imply any obligation on Bupa Care Services to employ you.
This form collects personal information about you for the purpose of assessing your suitability for employment at Bupa Care Services and, if employed, for the purposes of managing the employment relationship. Failure to provide all of the information requested may impair our ability to assess your suitability and compromise our ability to choose the right person for the position. Under the Privacy Act 1993 you are entitled to access and request the correction of any personal information held by Bupa Care Services.

Personal Details

First Name *

Surname *

E-mail *

Confirm E-mail *

Password *

Confirm Password *

Postal Address *

Location *

Phone *

Mobile/Other Phone

Upload Your CV * Uploads restricted to 2MB and file types .pdf .doc .docx .rtf .txt .html

Age

Have you reached the current school leaving age? (16 years)

Legal Work Status

Legally entitled to work in New Zealand?

A New Zealand Citizen?

A Permanent Resident?

A holder of a current Work Permit?

Please upload a copy of your New Zealand working eligibility, this can be in the form of a NZ or Australian passport/birth certificate or work visa Uploads restricted to 2MB and file types .pdf .doc .docx .rtf .txt .html

Health Practitioners only – Do you have a valid practising certificate?

If yes, please provide your Annual Practising Certificate Number

And the Certificate Expiry Date (dd/mm/yyyy)

Upload a Copy of your Annual Practising Certificate Uploads restricted to 2MB and file types .pdf .doc .docx .rtf .txt .html

Languages

List any languages that you can hold an everyday conversation in, other than English

Employment Background

Have you ever worked for Bupa Care Services or Guardian Health Care before?

If yes, where and when

Do you have secondary employment?

If yes, please detail

Medical

Do you consent to undergo a medical examination if you are offered employment?

Do you have/or have you had any medical or surgical condition, disability, mental health disorder or accident compensation (ACC) injury which may be aggravated by the job or affect your ability to work for Bupa Care Services in the particular position you applied for?

If yes, provide details

Are you vaccinated against...

Hepatitis A?

Hepatitis B?

Flu, this year?

Have you been working in a health facility overseas in the last 6 months or in a NZ health facility with MRSA outbreak?

Have you been in contact with any infectious illnesses within the last 6 months? eg Tuberculosis (TB), Scabies, Hepatitis?

Do you have any condition that would prevent you from wearing the necessary protective clothing? e.g. Gloves, masks, closed shoes, hearing protection, steel capped shoes etc.

Reference Consent

I consent to the above Bupa Care Services seeking verbal or written references on a confidential basis from my referees about me, and authorise any other information sought to be released for the purposes of ascertaining my suitability for the position for which I am applying. I understand that the information received by the Company is supplied in confidence as evaluative material and will not be disclosed to me.

Declaration

I declare that to the best of my knowledge the information provided in this application and in any resume or CV is accurate and I understand that if any false or misleading information is given, or any material fact suppressed, I will not be employed, or if I am employed, my employment may be terminated. I further understand that any offer of employment if made, is conditional on my obtaining a full medical certificate and / or police clearance certificate if required and requested by Bupa Care Services. *