Staff Details Form

Employee Information

Please complete the following staff details. This information is collected and held for human resource management, payroll and emergency purposes and will be handled in accordance with Confident Care Group’s privacy and confidentiality requirements.

First Name

Middle Name

Last Name

Date of Birth

Start Date

Position Title

Identify As

Male
Female

Car Registration

For staff parking and/or use of the car park.

Residential Address

Suburb

State

Postcode

Home Phone

Mobile Number

Email Address

Are you an Australian Citizen?

Yes
No

Are you a Permanent Resident?

Yes
No
Not Applicable

Do you have a Visa?

Yes
No
Not Applicable

Visa Type

Visa Expiry Date

Emergency Contact – Next of Kin Name

Relationship

Emergency Contact Address

Emergency Contact Suburb

Suburb any you

Emergency Contact State

Emergency Contact Postcode

Emergency Contact Home Phone

Emergency Contact Mobile

Do you have any pre-existing medical conditions and/or injuries?

Yes
No

If yes, please state the medical condition or injury

Do you have any allergies?

Yes
No

If yes, please state your allergies

Doctor’s Name

Doctor’s Contact Number

Consent

I consent to this information being collected, held and used for employment and emergency use only, and in accordance with the privacy and confidentiality policy.

Staff Details Form

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