New Hire Onboarding | Home Care Solutions

Step 1 of 10

Let’s Get Started

Choose how you were hired. If you’re not sure, ask your coordinator before continuing.

EmployeeYou’ll be paid as a W-2 employee with taxes withheld.Form W-4 Independent ContractorYou’ll be paid as a 1099 contractor without tax withholding.Form W-9

Your Legal Name

First name *

Middle

Last name *

Date of birth *

Position

Step 2 of 10

Contact & Emergency Info

We’ll use this across your forms so you only type it once.

Street address *

City *

State *

ZIP *

Cell phone *

Email *

Emergency Contact

Contact name *

Relationship *

Contact phone *

Step 3 of 10

Employment Application

Your availability, work eligibility and education.

Education

Fill in what applies — leave the rest blank.

High School

School name

City, State

Diploma / degree / certificate

From

To

Did you graduate / complete the program?YesNo

College

School name

City, State

Diploma / degree / certificate

From

To

Did you graduate / complete the program?YesNo

Other / Trade / Certification Program

School name

City, State

Diploma / degree / certificate

From

To

Did you graduate / complete the program?YesNo

Step 4 of 10

Work History & References

Previous employers and three professional references.

Previous Employment

New to the field? You can leave this blank.

Employer 1 (most recent first)

Company

Phone

Address

Supervisor

Job title

Starting pay

Ending pay

Responsibilities

Reason for leaving

From

To (blank if current)

May we contact this supervisor for a reference?YesNo

Professional References

Three references who know your work (not family members).

Reference 1

Full name *

Relationship *

Company

Phone *

Address

Reference 2

Full name *

Relationship *

Company

Phone *

Address

Reference 3

Full name *

Relationship *

Company

Phone *

Address

Step 5 of 10

Review & Agree

Open each document, read it, then check the box to agree. You’ll sign everything once at the end.

0 of 7 agreed

Step 6 of 10

Company Policies

Your initials *

Your initials are placed next to each policy you agree to below, exactly like initialing a paper form.

Step 7 of 10

Direct Deposit

Where should we send your pay?

🔒Encrypted before it leaves your device. Bank and Social Security numbers are locked so only Home Care Solutions’ office can open them, and they’re never saved in your browser.

Account type *

CheckingSavings

Bring a voided check (checking) or a routing & account printout (savings) to orientation.

Bank / credit union name *

Bank address (branch city is fine)

Routing number *That routing number doesn’t look valid — please double-check it.

Account number *

Confirm account number *Account numbers don’t match.

Social Security number *

Are you the account holder?YesNo

Name of the account holder *

I agree to have my funds deposited into this account. *

Email for paystub delivery

Authorization for direct deposit, pay card or paper check Tap to read — you’ll sign this at the end▼

Step 8 of 10

Background Check Consent

Georgia Department of Community Health — Acknowledgement of Applicant’s Non-Criminal Justice Privacy Rights and Consent.

I hereby authorize the Georgia Department of Community Health (DCH), Office of Inspector General, to receive any criminal history record information pertaining to me which may be in the files of any state or local criminal justice agency in Georgia. I understand a State and Federal fingerprint criminal background check will be conducted. By signing, I am indicating that I have read and understand the terms and conditions of the Non-Criminal Justice Applicant’s Privacy Rights and Policy Act Statements.

Your name, date of birth, address, email and phone from earlier steps are filled in for you. Facility: Home Care Solutions LLC, 3235 Satellite Blvd, Duluth, GA 30096.

Section I — Applicant type *

Section II — Georgia Caregiver Portal

The Caregiver Portal only lists people who passed screening. Family employers can use it to check eligibility before hiring caregivers for elderly family members. Choose one:

I agree to the results of my background check determination being available to family employers in the Georgia Caregiver Portal. I am seeking employment only by licensed healthcare employers. I do not want or agree to the results being available to family employers.

Section II — Applicant type (only if fingerprinted as part of facility licensure)

Step 9 of 10

Tax Form

Step 1(c) — Filing status * Single or Married filing separately Married filing jointly or Qualifying surviving spouse Head of household (only if unmarried and you pay more than half the costs of keeping up a home for yourself and a qualifying individual)

Complete Steps 2–4 only if they apply to you. Otherwise skip to the exemption question. For the most accurate withholding, use the IRS estimator at irs.gov/W4App.

Step 2 — Multiple jobs or spouse works

There are only two jobs total (you and/or your spouse) — check the box in Step 2(c). Do the same on the W-4 for the other job.

Step 3 — Claim dependent and other credits (income $200,000 or less / $400,000 if married filing jointly)

Qualifying children under 17× $2,200 = $0

Other dependents× $500 = $0

Other credits ($)Step 3 total: $0

Step 4 — Other adjustments (optional)

4(a) Other income ($)

4(b) Deductions ($)

4(c) Extra withholding / pay period ($)

Exemption

I claim exemption from withholding for 2026, and I certify that I meet both of the conditions for exemption. I understand I will need to submit a new Form W-4 for 2027.

Line 1 — Name (as shown on your income tax return) *

Line 2 — Business name / disregarded entity name (if different from above)

Line 3a — Federal tax classification *

LLC tax classification *

Other classification *

Line 3b — I have foreign partners, owners, or beneficiaries (partnerships, trusts/estates, or LLCs taxed as partnerships only).

Exempt payee code (if any)

FATCA exemption code (if any)

Part I — Taxpayer identification number *

Social Security numberEmployer ID number (EIN)

Uses the SSN you entered on the Direct Deposit step.

EIN *

Under penalties of perjury, by signing you certify that: (1) the number shown is your correct taxpayer identification number; (2) you are not subject to backup withholding; (3) you are a U.S. citizen or other U.S. person; and (4) any FATCA code entered is correct. Cross out item 2 by contacting the office if the IRS has notified you that you are subject to backup withholding.

Step 10 of 10

Review & Sign

Check your details, then sign once to complete every form in your packet.

Type your full legal name to sign *Please type your name exactly as entered in Step 1.

Date

I agree to sign electronically. My typed name is my legal signature and will be applied to each form in this packet that requires my signature, with the same effect as a handwritten signature.

Preparing your forms
Encrypting on this device
Uploading securely
Notifying the office

Welcome to the Team

Application & Onboarding Packet

Let’s Get Started

Contact & Emergency Info

Employment Application

High School

College

Other / Trade / Certification Program

Work History & References

Employer 1 (most recent first)

Employer 2

Employer 3

Reference 1

Reference 2

Reference 3

Review & Agree

Company Policies

Direct Deposit

Background Check Consent

Tax Form

Review & Sign

Onboarding Complete