First Name, Last Name, Email, Phone, Resume/CV, Location

• City
• State choose one
• Zip Code
• Do you consent to receiving SMS text messages from Wellthy? choose one
• Are you over the age of 18? choose one
• What languages do you speak fluently? (select all that apply) choose any
• I consider myself (select all that apply): choose any
• Travel Parameters: How far are you willing to travel for this role? choose one
• Care Notice Requirements choose one
• If you chose "Require a Minimum Notice" above, please provide the notice you will require below. optional
• Maximum number of children you will care for at one time (if applicable). choose one · optional
• Will you care for a child/adult in a home with a pet? choose one
• What ages do you have experience with? (select all that apply) choose any · optional
• Do you have experience caring for individuals with special needs or neurodivergent conditions? (Examples include autism, ADHD, physical disabilities, chronic illnesses, learning disabilities, etc.) choose one
• If you answered Yes to the question above, please specify the types of needs or conditions you have experience with (select all that apply) choose any · optional
• Will you provide any of the following services for the individual(s) needing care? (Please select all that apply) choose any · optional
• Do you have any relevant safety certifications (e.g., CPR, First Aid, Certified Nursing Assistant)? If so, please provide details about the certifications and how you keep them current. written answer · optional
• Hourly rate
• What forms of payment do you accept?(please select all that apply) choose any
• Please share details about your professional experience caring for children and/or adults (e.g. in-home care, center-based care, or family support). written answer
• Please introduce yourself written answer
• To ensure the well-being of those we care for and to maintain the highest standards of service, Wellthy has established a clear and comprehensive vetting and cancellation policy for families seeking in-home care. This policy is designed to provide clarity and fairness to all parties involved, ensuring that all parties involved are well-informed when participating in joining Wellthy’s network. Do you consent to a pre-screen and informational 15-min call with a Wellthy In-Home Care Specialist? choose one
• As a provider in the Wellthy network, you are expected to give more than 24 hours notice for cancellations. A first-time cancellation with less than 24 hours' notice will result in a flag on your account. If it happens again, you will be removed from the network and no longer able to support families. We are committed to providing reliable care, and we expect our providers to uphold this standard. Do you agree to our cancellation policy? choose one