Get Odh Form 805 Revised 082009

The Odh Form 805 Revised 082009 is the uniform employment application used for hiring nurse aide staff in various health care settings. This guide provides a clear and supportive overview of how to complete this form online, ensuring a smooth application process for all users.

Follow the steps to complete the Odh Form 805 online.

1. Press the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Begin with the personal information section. Enter your name, Social Security number, and any previous names you have used. Fill out your current address, permanent address (if different), phone number, date of birth, sex, race, and emergency contact information.
3. In the employment desired section, specify the position you are applying for, the salary you expect, and your availability for various work hours, including full-time, part-time, or occasional work.
4. Complete the U.S. military record section if applicable, providing details such as branch, entry and discharge dates, and type of discharge.
5. Detail your prior work history by listing up to four previous employers, including their names, addresses, phone numbers, your position held, supervisor names, dates of employment, salary, and reasons for leaving.
6. In the educational background section, list all schools attended, the type of studies completed, and any diplomas or certificates received.
7. If you hold a certification as a nurse aide, check the appropriate boxes for your certifications and list any additional skills, honors, or licenses not previously mentioned.
8. Provide references by listing the names, addresses, and contact numbers of three individuals who are not family members or former employers.
9. Complete the background information section carefully, responding to questions regarding past arrests or health care violations, and provide explanations if answering 'yes'.
10. Read and understand the applicant certification and agreement section, marking 'yes' or 'no' for each statement, and providing explanations for 'no' answers.
11. Fill out the previous CNA training section only if applicable, including training categories, program names, and start and end dates.
12. Initial in the notice box to confirm your understanding and provide your signature and date at the end of the application.
13. Once completed, save your changes, and use the download or print options to obtain a hard copy of your form, or proceed to share it as needed.

Begin your online application process today by filling out the Odh Form 805.