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Smeaton Healthcare Online Registration Form

Complete the registration form below to get started.

Full Registration Form

Personal Details

Next of Kin Details

Bank Details

About You

Work History

Please provide details of every employment you've been in, starting with your most recent. For additional employment information, please use the additional space below, ensuring you provide full details. 


Health Declaration

The following questions are to assist us in maintaining reasonable Health & Safety measures for our employees and to inform our clients to assist with ongoing Risk Assessments relating to employees being able to carry out their duties safely.

Equal Opportunities

Smeaton Healthcare are committed to a policy of Equal Opportunities for all of our Job Seekers. Smeaton Healthcare shall adhere to such a policy at all times and will review on an on-going basis all aspects of recruitment to avoid unlawful or undesirable discrimination. We will treat everyone equally irrespective of Sex, Sexual Orientation, Gender, Marital Status, Age, Disability, Colour, Race, Nationality, Ethnic or National Origin, Religion or Belief, Political Belief, Membership or Non-Membership of a Trade Union.

Criminal Convictions

*For further guidance on distinguishing "Spent" and "Unspent" criminal convictions, please refer to the guidance on the Rehabilitation of Offenders Act 1974. Certain types of employment and professions are exempt from the Rehabilitation of Offenders Act 1974 and in details for all criminal convictions must be given. The information given will be treated in the strictest of confidence and only taken into account where, in the reasonable opinion of the client, the offence is relevant to the post to which you are applying. Failure to declare a conviction may require us to exclude you from our register or terminate an assignment if the offence is not declared but later comes to light. Smeaton Healthcare also reserve the right to carry out an Internet search of all employees or workers that we may offer work to.

48 Hour Opt Out Agreement

I agree that I may work for more than an average of 48 hours a week. If I change my mind, I will give my employer 28 days notice in writing to end this agreement.

DBS Declaration

I hereby acknowledge and accept I will be liable for covering the costs of my DBS if I resign from Smeaton Healthcare limited within 3 months of my start date. 

Data Protection

The information you provide to Smeaton Healthcare will be used by Smeaton Healthcare to find you suitable assignments (agency) and/or to work as an employee of Smeaton Healthcare. In providing this service to you, you consent to your personal data being included on a computerised database and consent to us transferring your personal details to our clients. We may check the information collected, with third parties or with other information held by us. We may also use or pass to certain third parties information in any way permitted or required by law.

Data Consent

I consent to the Company processing the above personal data for the following purposes: For the Company to provide me with work-finding services (if applicable). For the Company to process with or transfer my personal data to their client/s in order to provide me with work-finding services (if applicable). For the Company to process my data on a computerised database in order to provide me with work-finding services. For the Company to process my data using automated decision-making processes I also consent to the Company processing my personal data with third parties if necessary. The consent I give to the Company will last for 2 years. I am aware that I have the right to withdraw my consent at any time by informing the Company that I wish to do so.


You must provide us with a minimum of 2 references in order to work with us. The first choice should be two professional references, however, if this is not possible - please provide character references and a member of our team will be in touch to discuss this. 


In order to speed up the recruitment process and prevent delays, please upload as many of the below files as you can. By uploading the files, you are consenting to Smeaton Healthcare storing these files on your electronic file.


I hereby declare that the information provided is true and correct. I also understand that any willful dishonesty may render for refusal of this application or immediate termination of employment. If this application is successful, I authorize Smeaton Healthcare to keep this information in my personal file, otherwise, all information will be destroyed within 3 months after the date of application. I also understand I am entitled to update and correct the above information and agree that this information could be held for 3 months from the date of application and used for future recruitment by Smeaton Healthcare.