Dear Candidate,
Thank you for your enquiry to Australian Medical Services Nursing Agency.
We are an Australian owned and operated agency in Northern Sydney which values its staff and clients. We
believe in providing:
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Quality care to patients
A confident service to health providers and hospitals
A personal and friendly agency for Nurses to work. We recognise your needs as Nurses and provide a
free uniform as well as a great rate of pay with a weekly payment system.
Below is a summary of information required to bring to interview for Australian Medical Services. Please
ensure you have everything listed below to continue to advance through the application process.
All staff need a 100 - Point Identification Check to work in the agency.
Please bring ORIGINAL and COPIES of your current Passport and two of the following identifications:
Drivers licence
Medicare card/ private insurance card
Birth Certificate
Marriage Certificate
Citizenship certificate
Government issued license
Proof of age card
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NSW Police Check certificate AND current Working With Children Check
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Original identifying documents and copies of APHRA registration
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Copies of certificates/ Proof of years of experience.
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Non residents must bring in their original identifying documents and copies of passports and Visa
documents.
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Evidence of mandatory education: ie: CPR training, Manual handling, First Aid etc.
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Documentation of Immunisation updates
Please fill in the personal details and AMS membership agreement below and bring to the interview.
If you have any questions with the application process please feel free to phone or email us at
ams.agency@ausmedserv.com.au and we will be happy to help you
We look forward to working with you at Australian Medical Services Nursing Agency
Many thanks ………
PERSONAL DETAILS
First Name: ______________________ Surname: ______________________
Australian Resident: Yes/No - Visa Expiry date: _______________________
D.O.B: _______________________ T.F.N____________________________
Address: _______________________________________________________
Email: _________________________________________________________
Home Phone:_______________________ Mobile: ______________________
Nurses Reg No: __________________ Expiry Date: ________Classification:____
Years Of Service____________ (Original and copies rqd)
Super Fund: ______________________ Member No.: ____________________
Medicare number:_________________________________________________(Original and copies rqd)
Are you an Australian citizen:___________ (If not a copy of work visa needs to be supplied)
Visa Expiry:___________________ Drivers Licence Number_______________ (Originals and copies rqd)
AVAILABILITY:
Monday___________Tuesday___________Wednesday________Thursday______
Friday ____________ Saturday ____________ Sunday______
BANKING DETAILS
Actual Name on Account: ___________________________________________
Bank Name: _______________________ Branch: ________________________
BSB: ________________________ ACCOUNT#: ________________________
PROFESSIONAL EDUCATION
Do you annually update your CPR skills? Yes/No
Are you updated on Manual Handling? Yes/No
Do you attend professional development sessions annually? Yes/No
Please provide evidence of any other further education/ certificates held, as well as documentation for the above.
Please provide evidence for Immunisation for the following:
Tuberculosis
Hepatitis B
Tetanus
Rubella
Diptheria
Mumps
Measles
Chicken Pox
Polio
Signed __________________________________ Date: ___________________________
WORKERS COMPENSATION
Do you have any pre existing allergies/ illness/ injuries that may be affected by the services you intend to
provide? Yes/ No
If so please provide details of illness or injury _____________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Have you ever claimed on Worker’s Compensation? If so please provide details.
__________________________________________________________________________________________
__________________________________________________________________________________________
All information provided will be held strictly confidential.
EMERGENCY CONTACT
In the case of injury or an accident we will contact this person on your behalf.
Name: _________________________ Relationship to you: _______________________
Home Phone: _______________________ Mobile: _____________________________
REFERENCE CHECK
I ____________________________________________ hereby nominate the individuals
listed below to act as referees on my behalf and give authorisation to Australian Medical Services Nursing
Agency to contact these individuals.
I confirm that I have advised the individuals listed below that I have provided their names and contact details for
the purpose of seeking a reference.
I also authorise Australian Medical Services Nursing Agency to pass on to its clients, information obtained from
my referees that is relevant to any position registered with Australian Medical Services for which I may apply
or be considered suitable.
Signed: _______________________________________ Dated: ______________________
REFEREE DETAILS:
Name: ______________________________________________
Position: ______________________________________________
Company: ______________________________________________
Address: ______________________________________________
Contact Phone: __________________ Email: _____________________
Name: ______________________________________________
Position: ______________________________________________
Company: ______________________________________________
Address: ______________________________________________
Contact Phone: __________________ Email: _____________________
I certify that the above information is to the best of my knowledge, true and accurate in every
detail.
Signed: _____________________________ Dated: ____________________________
Membership agreement
There is an agreement between the Australian Medical Services Agency and the Nurse/Midwife to secure work
in hospitals/nursing homes and home care.
1. The Nurse/ Midwife is a casual employee of the agency. The agency will pay and complete
administrative functions on behalf of the hospital and the Nurse/Midwife who has provided the service.
The nurse will need to therefore advise the agency of personal detail changes to enable efficiency with
the administrative process.
2. The Nurse or Midwife will complete a timesheet before leaving their shift which will act as an invoice
for the hospital and agency. The timesheet will need to be signed from an in - charge hospital
representative, and then sent by mail to the agency for payment of the shift.
3. The Nurse/Midwife will inform the agency of their availability for coordination purposes.
4. The Nurse/Midwife has the opportunity to accept or decline the offer of a shift by the agency on behalf
of the hospital.
5. On acceptance of a shift the Nurse/Midwife is committed to attending and providing a quality service to
the Hospital. If the circumstances change and the Nurse/Midwife cannot attend the shift, the
Nurse/Midwife must advise the Agency so that the hospital can be notified immediately.
6. The Nurse/Midwife understands that they must follow the guidelines, directions on protocols, standard
of patient care and how it is delivered and comply with OH & S requirements of the hospital. The
Nurse/Midwife understands it is their responsibility to practice safely and for updating their annual
education and training in CPR, OH&S, Manual Handling and Infection Control.
7. As a casual employee of the AMS agency, there are no entitlements for annual leave, sick leave, and
long service leave. The hospitals require we have a professional indemnity policy in place to cover
nurses and the hospital.
8. The Nurse/ Midwife needs to wear the AMS uniform of blue scrubs, with non slip - covered shoes and
their identification badge. It is the Nurses responsibility to look professional in their appearance as a
representative of AMS Nursing Agency.
9. The Nurse/ Midwife will be responsible for their travel expenses to and from the hospital, as well as
equipment such as torches, scissors, stethoscopes etc that may be required to carry out your shift.
10. Currency of registration needs to be viewed as an original document when joining the agency. Once
received the registration can be viewed on a public register on the APHRA website. So the yearly
renewals will then be documented by the agency for legal purposes as per required by the hospitals and
work places. If not renewed the Nurse /Midwife will not be able to practice as per the APHRA
guidelines. Please inform the agency before your next shift/ within 12 hours if your registration is
suspended or cancelled.
11. The Nurse/Midwife must carry their current practicing registration with them to their workplace, as the
hospitals have the right to confirm your experience. Hospitals reserve the right to cancel your shift if you
are unable to confirm your practicing criteria.
12. The Nurse/Midwife must remain respectful of patient’s confidentiality. Always remain within the law
nor be intoxicated with alcohol or any other substance whilst on duty, carrying out your duty in a
professional, honest and sincere manner.
Please sign the agreement below once all the terms have been read.
I____________________________ have read and understand the agreement.
Signed ______________________ Date_____________________________
Signed on behalf Of AMS Agency – Signature ____________________________
Date _________________________________________________________