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Employment History Validation



The CQC requires that carers disclose a full employment history, together with a satisfactory written explanation of any gaps in employment. A “full employment history” means a career history from the age of first employment.In this form please outline all periods of employment or self-employment (whether or not related to health or social care), showing beginning and end dates, together with an explanation of periods of non-employment.

Please do not leave any gaps in your history otherwise you will be asked to submit this form again

Candidate Details

e.g 05/1990
For Employment: Include Employment Name, Employer Address, Position Held, and Responsibilities Held, and Reason for Leaving.


For Education: Include Name of School/College/University and Qualifications Obtained.


For Unemployment: Include Reason for Unemployment.

HR Notes

I hereby declare that the information provided is true and correct. I also understand that any willful dishonesty may render for refusal of this application or immediate termination of employment.