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Home
Our Hospital
About JSH
Patient Visiting Hours
Pharmacy
Olivia’s Coffee Shop
Parking
News, Stories and Updates
Departments
Emergency Unit
Specialists
Icon Oncology
Radiology
SJF Breast Care Centre
Find a Doctor
Patient Information
Pre-Admission
Addmission
Post-Op
Your Medical Aid
Patient Care Survey
Frequently Asked Questions
Patient Visiting Hours
Contact Us
Emergency Unit
Reception/Switchboard
Radiology
Claims/Accounts
Ampath Laboratories
Lancet Laboratories
Career Related Queries
Complaints & Compliments
Career Opportunities
Emergency Number: 011 593 4488 or 011 593 4490 | Switchboard: 011 593 4477
Full Name
Initials
Preferred Name
Date of Birth
ID
Gender
Male
Female
Ethnicity
Black
Coloured
Asian
White
Indian
Other
Are you a South African Citizen
Yes
No
If you answered no to the above question, do you have a permit to work in South Africa?
Yes
No
Mobile Number
Landline Number
Alternative Number
Email
Residential Address
Postal Address
Are you applying for part time or full time?
Part Time
Full Time
How did you hear about this position?
Do you have any physical health limitations that will prevent you from performing the job you are applying for?
Yes
No
If yes, please provide details.
Where applicable, and in the execution of your normal duties, you may be exposed to certain health risks.
The following are examples of such health risks:
- Manual handling of objects or patients (i.e. muscular-skeletal problems, back-, neck- or shoulder pain)
- Latex (i.e. dermatitis, asthma)
- Radiation (i.e. pre-malignant or malignant condition)
- Chemicals (i.e. dermatitis, asthma, chronic bronchitis)
If you have any of the above or another condition that may be worsened and may have an impact on your appointment, please disclose such information below
Company 1
Position
Time in this position
Contact Persons Name
Contact Persons Contact Number
Company 2
Time in this position
Position
Contact Persons Name
Contact Persons Contact Number
Company 3
Position
Time in this position
Contact Persons Name
Contact Persons Contact Number
Do you have a license or registration to perform the work you are applying for?
Yes
No
Not applicable
Registration Type
Registration Body
Registration Number
Registration Date
Expiry Date
Renewal Date
Country Issued
Consent
It is in both your and the Company’s best interest to perform integrity assessments prior to employment. An integrity assessment involves compiling a comprehensive background check relevant to the job that will be performed.
One or more of the following methods are used:
- Reference check with referees as supplied
- Qualification check
- SANC check (if applicable)
- Credit and/or criminal check
I hereby voluntarily provide consent for an integrity assessment to be carried out on me.
I accept that the integrity assessment is part of the pre-employment selection process and that Cintocare is under no obligation to make use of my services. Please note that the information gathered will be dealt with on a strictly confidential and discreet basis.
Is there any other information, which may have a bearing on your suitability for the position?
Yes
No
If Yes, please detail (eg. Nature, date, etc.)
Upload your CV Here
Declaration
I hereby declare that all particulars and answers in this application form are true and no material fact has been withheld. I agree that this application and declaration shall be the basis of any contract between the Company and me, that the withholding of any material information or failure to answer the questions correctly will constitute a breach of a condition of my employment (if I am successful in my application) for which I may be dismissed.
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