Career

APPLICANT CATEGORY *

Graduate of an HCA Program in BC - Completed HCA program at a BC educational institution Graduate of an HCA program in Lower Mainland (or HCA equivalent) - Completed HCA program at Canadian institution outside BC
Please select the category that best describes your situation:

PERSONAL INFORMATION

Legal Name

First Name

Middle Name

Last Name

Preferred Name (if different)

Phone Number *

Email

Date of Birth

Gender
Male Female Other

Street Address *

City *

Province / State *

Postal Code *

Country *

Mailing Address (if different):

Street Address *

City *

Province / State *

Postal Code *

Country *

Name Change Documentation (if applicable)
Marriage Certificate Certificate of Name Change Not Applicable

Mailing Address (if different):

For BC HCA Program Graduates

Educational Institution

Program Name

Program Completion Date

Program Duration

Required Documentation (submit one):

Important: Transcripts must show final grades for all required HCA courses. Incomplete transcripts indicating the program is still in progress are not accepted.

Certificate Official Transcript Unofficial Transcript Official letter of completion from educational institution

Documentation File Upload

If your education credential is more than 3 years old

Resume outlining recent and relevant HCA work experience attached May be required to complete HCA competency evaluation

For Canadian HCA Program Graduates (Outside BC)

Educational Institution:

Province/Territory:

Program Name:

Program Completion Date:

Required Documentation:

Certificate/Diploma/Degree Official Transcript

Documentation File Upload

BACKGROUND CHECKS AND SCREENING

Criminal Record Check

Have you completed a Criminal Record Check through the BC Criminal Records Review Program?

Yes No In Progress

Date of Criminal Record Check:

Reference Number:

Health Screening

Have you completed tuberculosis screening as required?

Yes No

Date of TB Screening:

Health Care Provider:

Are you vaccinated for Covid:

EMPLOYMENT INFORMATION

Current Employment Status:

Employed as HCA Seeking HCA employment Student Other

Current/Most Recent Employer (if applicable):

Employer Name

Position Title

Employment Dates:

Type of Health Care Setting:
Public Health Authority Private Home Care Assisted Living Long-term Care Community Health Other

Note: Other Information that Agency needs to know:

DECLARATIONS AND CONSENT

Applicant Declaration

I declare that:

All information provided in this application is true, complete, and accurate.

I understand that providing false or misleading information may result in denial of registration or cancellation of existing registration.

I will notify the Registry immediately of any changes to the information provided.

I understand the responsibilities and obligations of registered care aides and community health workers.

I agree to comply with the Registry's standards of practice and code of conduct.

I have read and agree to the Applicant Declaration.

Consent for Information Sharing

I consent to:

The Registry verifying information with educational institutions, employers, and regulatory bodies.

The Registry sharing my registration information with employers and health authorities as required.

The Registry conducting periodic audits of my registration status and qualifications.

The collection, use, and disclosure of my personal information as outlined in the Registry's privacy policy.

I have read and give my consent.

Professional Conduct Agreement

I agree to:

Maintain professional standards in all aspects of my work.

Report any incidents or concerns related to client safety or care quality.

Participate in continuing education and professional development as required.

Notify the Registry of any criminal charges or convictions.

Work within my scope of practice and competency level.

I have read and agree to the Professional Conduct Agreement.

Signature *

Sign Date:

Sign Date:

REQUIRED DOCUMENTS CHECKLIST

Please ensure all required documents are submitted with your application:

Documentation File Upload

All Applicants
Completed application form Copy of government-issued photo identification Criminal record check (BC Criminal Records Review Program) Tuberculosis screening results Application fee payment

Education-Specific Documents
Educational transcripts/certificates (as applicable to your category) Professional license verification (for licensed nurses) Educational credential assessment (for international applicants) Resume (if education is more than 3 years old or as required)

Name Change Documents (if applicable):
Marriage certificate Certificate of name change

Phone:

United Respite Care inc.

PERSONAL INFORMATION

Mailing Address (if different):

Mailing Address (if different):

For BC HCA Program Graduates

Required Documentation (submit one):

Important: Transcripts must show final grades for all required HCA courses. Incomplete transcripts indicating the program is still in progress are not accepted.

Certificate Official Transcript Unofficial Transcript Official letter of completion from educational institution

Documentation File Upload

If your education credential is more than 3 years old

Resume outlining recent and relevant HCA work experience attached May be required to complete HCA competency evaluation

For Canadian HCA Program Graduates (Outside BC)

Required Documentation:

Certificate/Diploma/Degree Official Transcript

Documentation File Upload

BACKGROUND CHECKS AND SCREENING

Criminal Record Check

Have you completed a Criminal Record Check through the BC Criminal Records Review Program?

Yes No In Progress

Health Screening

Have you completed tuberculosis screening as required?

Yes No

EMPLOYMENT INFORMATION

Current Employment Status:

Employed as HCA Seeking HCA employment Student Other

Current/Most Recent Employer (if applicable):

Note: Other Information that Agency needs to know:

DECLARATIONS AND CONSENT

Applicant Declaration

Consent for Information Sharing

Professional Conduct Agreement

REQUIRED DOCUMENTS CHECKLIST

Please ensure all required documents are submitted with your application:

Documentation File Upload

All Applicants Completed application form Copy of government-issued photo identification Criminal record check (BC Criminal Records Review Program) Tuberculosis screening results Application fee payment

Education-Specific Documents Educational transcripts/certificates (as applicable to your category) Professional license verification (for licensed nurses) Educational credential assessment (for international applicants) Resume (if education is more than 3 years old or as required)

Name Change Documents (if applicable): Marriage certificate Certificate of name change

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Send A Message

Send us Messege And We Will Get Back To you ASAP!

Call Our Office

(778) 561-5882

Contact Information

(778) 561-5882

info@unitedrespitecare.ca

8661 201st Street 2nd Floor Langley British Columbia V2Y 0G9 Canada

Connect with Us

Services Areas:

All Applicants
Completed application form Copy of government-issued photo identification Criminal record check (BC Criminal Records Review Program) Tuberculosis screening results Application fee payment

Education-Specific Documents
Educational transcripts/certificates (as applicable to your category) Professional license verification (for licensed nurses) Educational credential assessment (for international applicants) Resume (if education is more than 3 years old or as required)

Name Change Documents (if applicable):
Marriage certificate Certificate of name change