Reference Form

Your reference supports a safer environment for those we care for. For further information, feel free to contact us on 0208 050 2061

Clinical Reference Request Form

Referee Information

*Are you the candidates line manager?


Candidate Information

*Is Candidate still working with you?

*Do you object to us discussing the contents of this reference with the candidate?


Candidate Performance

Very PoorPoorAverageGoodVery Good
Attendance?
Honest & Trustworthy
Professionalism?
Punctuality
Ability to do the job?
Ability to work with others?
Ability to receive feedback/criticism?
Ability to adapt?
Willingness to learn?
Willingness to participate?
Work ethic?
Quality of work?


Candidate Traits

Rate the candidates' overall positive qualities


Professionalism

Have you referred the Applicant to DBS (England & Wales), SSSC (Scotland), NMC or any other regulatory body or professional body?
Are there any specific reasons or concerns that lead you to question the candidate's suitability for a care environment that serves a diverse range of vulnerable individuals?
Has the applicant been subject to any concerns regarding safeguarding issues or disciplinary investigations/procedures?


Seek Staffing Members

Not a Member?  SIGNUP now

Sign in

Username
password *

Reset Password

User login/email