Register With Us

March 5 2026
luciadmin

📋 Register With Us

Complete the form below to apply to join the Lucia Healthcare team. Fields marked * are required.

Personal Details

First Name *

Middle Name

Last Name *

Gender

Date of Birth *

Nationality *

Email *

Phone *

National Insurance Number *

Address

Address 1 *

Address 2

City *

Post Code *

Referee

Referee 1 Name *

Referee 1 Email *

Phone *

Referee 2 Name *

Referee 2 Email *

Referee 2 Phone *

DBS Information

Do you have an existing enhanced updated DBS? *

Proof of Address

Please provide any 2 of your Driver's Licence, Bank Statements, Utility Bill or Payslip issued in the last 3 months. (We accept pdf, jpg, jpeg, png, doc, docx files, with max size of 5mb)

Proof of Right to Work

Do you have permission to work in the UK? *

If you have selected Yes above, please provide a proof of your right to work, for example, a British Passport, Visa or Biometric Residence Permit (BRP), UK Birth Certificate, etc. (We accept pdf, jpg, jpeg, png, doc, docx files, with max size of 5mb)

Others

Please provide your CV with Full Care Work history. (We accept pdf, jpg, jpeg, png, doc, docx files, with max size of 5mb)

Do you drive or own a car? *

Have you ever been convicted of an offence? *

Bank Details

Account Holder Name

Bank Sort Code

Account Number

Declarations

I am happy for Lucia Healthcare to represent me and provide my details for any Healthcare Support jobs in the UK.

I certify that the information on this form is to the best of my knowledge correct. I understand that any engagement entered into will be subject to satisfactory checks and references.

📋 Register With Us

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