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Background Fingerprint Screening Process

***Application Form and Additional Information Required***

Dear Applicant,

As part of the onboarding process with An Extra Hand Home Care, we need you to complete the Application Form for the GADCH Georgia Criminal History Check System. This is the first step in completing the background fingerprint screening process.

To proceed, please follow the instructions below:

  1. Click on the link provided to access the Application Form: ACKNOWLEDGEMENT OF APPLICANT'S NON-CRIMINAL JUSTICE PRIVACY RIGHTS AND CONSENT TO BE INCLUDED IN THE CAREGIVER PORTAL
  2. Complete the Application Form with accurate and up-to-date information.
Please find below the necessary Facility information, Applicant Type, and Agreement for your reference in completing the form:

 

Name of Facility: An Extra Hand Home Care, LLC

Facility Address: 2221 Peachtree Rd, Ste D 375, Atlanta, GA 30309

Applicant Type: Select - Applicant for Employment/Direct Access Employee (Licensed Facility)

Select - I agree to the results of my background check determination being available to family employers in the Georgia Caregiver Portal

Applicant's email address
What State were you born in? If not born in the USA, what city or province were you born in?
Were you born in the U.S.A? If not, what country were you born in?
Do you have your CNA or PCA caregiver certification currently in the state of Georgia to work legally as a caregiver?
CNA or PCA Certification Number
Date of Expiration
Are you a Certified Caregiver in any other states? If so, please specify the other states you are licensed in.
Sign your name
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Employer: An Extra Hand Home Care