Golden Touch Home Health Application HiddenNext Steps: Install the Survey Add-OnThis form requires the Gravity Forms Survey Add-On. Important: Delete this tip before you publish the form.Golden Touch Home Health welcomes all caring and reliable caregivers to join. Please fill in the following application to apply. We will contact you as soon as possible.Name(Required) First Name: Last Name: Phone Number(Required)ZIP Code(Required)Email Gender(Required) Male Female keep secretCan you start working immediately?(Required) Yes NoWhich language do you speak? (multiple choice)(Required) English Mandarin Cantonese Taishan dialect Hakka Fuzhou dialect Shanghainese spanish Korean Japanese vietnamese otherWhich area is acceptable for working?(Required) Manhattan Brooklyn Queen Bronx Staten island Westchester countyAvailable working hours per week? (multiple choice)(Required) Monday Tuesday Wednesday Thursday Friday Saturday SundayAre you accepting "stay-in care"? (Need to stay overnight at the care patient's home)(Required) Yes NoEmailThis field is for validation purposes and should be left unchanged.