Caregiver Reference Check Form

Candidate Name Reference Name Reference Relationship Reference Phone Reference Email

How long have you known the candidate? In what capacity have you worked with the candidate?

Please describe the candidate's reliability and punctuality. Please comment on the candidate’s communication skills. How does the candidate handle stressful or difficult situations? Would you trust the candidate to care for a vulnerable person? Please explain. Are there any concerns or reasons why this person should not be a caregiver?

Additional comments