Employment Application

Most fields are required, especially those marked with asterisks. By submitting this form, you certify that all answers are true and complete to the best of your knowledge. If this application leads to employment, you understand that false or misleading information in your application or interview may result in your release.

Date: *
Applicant Full Name: *
Street Address: *
City: *
State: *
Zip: *
Social Security Number:
Date of Birth:
Position Applied For:

	YES
United States Citizen? (If No, go to next question): *
	NO
Authorized to Work in United States?	YES
	NO
Convicted of Felony?	YES
	NO
Would you submit to a BCII / FBI Check	YES
	NO
Education:
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AMEN Medcare - OPTIMISTIC Medical

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You have just arrived at a 1-STOP friendly shop for all your home care needs. Our physical location is 270 Northland Boulevard Cincinnati Ohio 45246. Founded in 2004, our company has been known to provide top quality services to the elderly and people with disabilities in the metropolitan Cincinnati Area. Current Counties served by our company are Hamilton, Clermont, Butler, and Montgomery. Our goal is to add value to the needs our loyal customers while at the same time offer unparalleled services and competitive prices for our medical equipment.

We are a name you can rely on for all your homecare needs!

Amen: (513) 771-0464
Optimistic: (513) 771-3378

Fax: (513) 771-3381

Optmistic is provider of durable medical equipment. While we deeply focus on providing suitable equipment and supplies for our senior citizens, we do also carry products that are prescribed for the care of children and young adults who may be physically challenged.

Amen Medcare provides Homemaking and Personal Care Services to seniors and other individuals faced with certain difficulties in carrying out their daily living activities. Our direct support professionals receive extensive training and certification in nurse aide services and a background-check is performed before they begin to provide services.