Forms

Below you will find some of the forms that are necessary for employment with Specialty Professional Services, Corp. Most of these forms will be mailed or emailed to you in your new hire employment packet. However, we are placing some of them here for your convenience. You may download these forms and print them to fill out, then you simply need to mail, email, or fax them back to us

Headquarters:
17-20 Whitestone Expressway
Suite 303
Whitestone, NY 11357

Fax: 718-225-9421 or 646-736-0190

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Application Packet
Below you file find our hiring packet. Please review the below and complete all the documents below:

1. Electronic Charting Systems
2. Employment Application (PDF)
3. Employment Application (Word Doc)
4. Letter of Reference (2 Required)

Job Descriptions
Below you file find descriptions for the jobs we are currently placing. Please review the below documents which best fits your experience.

1. CNA Job Description
2. LPN Job Description
3. ORT Job Description
4. RN Job Description

Payroll / HR Forms
Below you file find our payroll and human resources forms. Please review the below and complete all the documents below:

1. Direct Deposit Authorization
2. FCRA-Background Consent Form
3. Health Insurance Waiver Form
4. I-9 Employment. Eligibility Verification
5. New York State Law Article-23A
6. Standards & Expectations (NY)
7. Time Sheet (client must sign-off on to get paid)
8. W11 - HIRE Act Employee Affidavit
9. W-4 Tax Witholding Form (2017)

Medical Health Forms
Below you file find our medical health forms. Please review the below and complete all the documents below:

1. Communicable Disease Questionnaire
2. Hepatitis B Vaccination Declination
3. Influenza Vaccination (Consent or Declination Form)
4. MASK Fit & Questionnaire
5. OSHA / HIPAA Mandates
6. Physican's Statement (Annual)
7. Tetanus Vaccination Declination