Professional Reference Candidate Name * Candidate Name First Name First Name Last Name Last Name Reference Name * Reference Name First Name First Name Last Name Last Name Phone Number * Email * Company Name * Position Applied For Healthcare AssistantSupport WorkerNurseOther Position Applied For Candidate’s Honesty * 1 2 3 4 5 1 = poor 5 = excellent Candidate’s Reliability * 1 2 3 4 5 1 = poor 5 = excellent Candidate’s Timekeeping * 1 2 3 4 5 1 = poor 5 = excellent Capable of taking responsibility * 1 2 3 4 5 1 = poor 5 = excellent Communication skills * 1 2 3 4 5 1 = poor 5 = excellent Is his/her attendance satisfactory * YesNo Would you re-employ this person if a suitable vacancy was available? * YesNo Please comment on any particular strengths or weaknesses of the candidate How many sickness days has the candidate taken in the last 12 months? Is/has the candidate been subject to any disciplinary matters/suspension/dismissal or safeguarding issues? If yes, please give details Dates of Employment Reason for leaving if applicable Date Signature signature keyboard Clear Submit If you are human, leave this field blank.
