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Employment Reference - Nurse / Caregiver

We appreciate that your time is limited and offer our thanks, on the behalf of the candidate, for completing this Employment Reference - Nurse / Caregiver, to provide insight into the quality of the candidate and his / her suitability for a role here in Bermuda. Your responses will be held in strict confidence and will not be shared with the candidate at all.  This professional reference will take 10 mins to complete. 

If you have any questions, please send an email to Barbara R. Tannock, Director at:

Thank you again for your time. 

I / We are submitting a reference for: *

Candidate's Job Category: *

Today's Date:*

What is your name? Person completing this Employment Reference. *

Where do you currently work? And what is your current role?

Where did you work with this Applicant? / how do you know the applicant?

I submit in this capacity: (Choose all that apply)

Clinical Competency (Check one):





Adaptability / Flexibility:


Grooming (Personal, Hygiene, Uniform):

This candidate gets along well with others. *

Select an option

Applicant handles stressful situations well. *

Select an option

I believe the applicant is honest and trustworthy. *

Select an option

I have trust the applicant would keep private information confidential. *

Select an option

I have not witnessed any displays of discrimination in his / her delivery of care. *

Select an option

I do not have knowledge of the candidate's use or involvement with illicit drugs or narcotics. *

Select an option




English Fluency: Please assess the candidate's command of the English Language.

Would you re-hire this candidate? Please explain your answer.

Is there anything else that you would like to share with us as we consider this application?

What is your best contact number?

What is your Email Address?*

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