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Reference Request for Agency Worker

The document is a reference request for an applicant being considered for an agency worker position. It includes a form for the referee to assess the applicant's clinical skills, knowledge, reliability, and other relevant attributes. The request emphasizes the need for prompt feedback and includes a section for any concerns regarding the applicant's suitability for working with vulnerable populations.

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Hemant Hulkory
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50 views2 pages

Reference Request for Agency Worker

The document is a reference request for an applicant being considered for an agency worker position. It includes a form for the referee to assess the applicant's clinical skills, knowledge, reliability, and other relevant attributes. The request emphasizes the need for prompt feedback and includes a section for any concerns regarding the applicant's suitability for working with vulnerable populations.

Uploaded by

Hemant Hulkory
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

REQUEST FOR A REFERENCE FOR NAME HERE

The above-named is being considered as an agency worker with our company and has indicated that
you would be willing to provide a reference. I should be grateful if you would complete the enclosed
reference request form and comment on how this candidate would meet the requirements of the post.

May I take this opportunity to thank you in advance for your assistance; your prompt reply would be
much appreciated.

Yours sincerely

Josiah Awobayiku
Managing Director

Reference request
Applicant name Post applied
for
Dates in From: To:
employment [dd/mm/yy] [dd/mm/yy]

Applicant assessment
Please tick appropriate boxes
Less than
Clinical skills Excellent Good Satisfactory
satisfactory Unsatisfactory
Clinical Less than
Excellent Good Satisfactory
Knowledge satisfactory Unsatisfactory
Quality of Less than
Excellent Good Satisfactory
work satisfactory Unsatisfactory
Less than
Reliability Excellent Good Satisfactory
satisfactory Unsatisfactory
Relationship Less than
Excellent Good Satisfactory
with satisfactory Unsatisfactory
colleagues
Communicati Less than
Excellent Good Satisfactory
on satisfactory Unsatisfactory
Less than
Punctuality Excellent Good Satisfactory
satisfactory Unsatisfactory
Have there been any disciplinary/other formal employment proceedings against the applicant within the past two
years? YES NO
Do you have any reservations regarding this person working with children, young people or vulnerable adults?
YES NO
Subject to a suitable vacancy arising, and policy permitting, would you re-employ this person?
YES NO

If you have answered ‘NO’ or ‘UNSATISFACTORY’ to any of the above, please provide details:

Referee details
Referee Position
name
NHS band Organisation
Signed:
Date:

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