Thank you for your interest in working with Accucare Pediatric Nursing & Home Care. Please fill out our employment application.

Please sign and date two copies of the bottom of the reference request and we will mail it out from the agency. Please fill out the I9 and W4 forms. Completed forms can be emailed to

If you’ve had a physical with PPD and immunization information within the past twelve months, with ALL of the BODY SYSTEMS included, you may bring a photocopy of it. If not, you can Download a Physical Form for your physician to complete.

These are the forms you will need to begin the application process:

  1. Original New York State licensure, certificate, and registrations.
  2. Current malpractice insurance with expiration date.
  3. Proof of citizenship /eligibility to work in the United States; completed I-9 form, alien registration which allows employment in the U.S., passport, social security card (original) or see the back of the I-9 form for other acceptable documents.
  4. Two recent employment references containing length of employment, job performance, position, and if possible the reason for leaving. Our office will submit reference request with your signed release. Please sign and date the enclosed forms. DO NOT FILL OUT– Please bring them into the office when you schedule your initial orientation and we will mail them out.
  5.  Valid Driver’s License or Non-Driver Identification Card.
  6.  Valid liability insurance, automobile registration and current inspection.
  7.  Continuing education required for re-license on Infection Control.
  8.  Current CPR
  9.  NPI number