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Reference Request Form

Verve Homecare Ltd requires two professional references for candidates to ensure they possess the necessary experience for healthcare roles. The reference form for candidate Hanan Ismail indicates satisfactory to excellent ratings across various skills, with positive comments about her reliability and eagerness to learn. The referee, Linda Chikumira, confirms no disciplinary actions against Hanan and expresses willingness to re-employ her, noting she left for another job opportunity.

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0% found this document useful (0 votes)
6 views4 pages

Reference Request Form

Verve Homecare Ltd requires two professional references for candidates to ensure they possess the necessary experience for healthcare roles. The reference form for candidate Hanan Ismail indicates satisfactory to excellent ratings across various skills, with positive comments about her reliability and eagerness to learn. The referee, Linda Chikumira, confirms no disciplinary actions against Hanan and expresses willingness to re-employ her, noting she left for another job opportunity.

Uploaded by

lchikumira
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Verve Homecare Ltd

Employer Reference Request

To Whom it May Concern,

Part of the Verve Homecare registration procedure is that a minimum of two


professional/ clinical references are followed up and carried out. This is to ensure that
our candidates who are successfully registered and placed out to work have the
required amount of experience to continue working within the healthcare sector with
our agency.

This reference form is not only for the benefit of placing suitable and well experienced
agency workers to yourself, but also for our current and potential client database.

Therefore we would be extremely grateful if you would take some time to go through this
reference form and answer as accurately Oreva@[Link] possible, in
regards to the named agency worker below.

Signed and dated references can be returned via fax on: 0207 206 8969. In addition, they
can be emailed to: or posted to: Verve Homecare Ltd, Exchange Tower, 1 Harbour
Exchange Square, E14 9GE.

*Please ensure that all references are completed in full and accompanied
with either a signed compliment slip or workplace stamp.

Many thanks in advance,

Verve Homecare Ltd, Compliance Team


Name of Candidate: Hanan Ismail Position: HCA

Dates in your Employment: Month & Year From: 15/01/2023 Month &

Year To: 20/02/2026

Please confirm if you are senior to candidate: YES NO

POOR SATISFACTORY GOOD EXCELLENT UNABLE TO


COMMENT
Clinical Skills and X
Experience
Organisational Skills X

Attitude to work and X


training
Relationship with X
patients
Time Keeping X
Record Keeping X

Please specify if you have any further / more detailed comments: Relating to
clinical knowledge, organizational skills or management skills:
Hanan is a responsible,reliable and honest carer. She is proffesional hardworking and
understands her role well.
Hanan is knowledgeable and works within her limitations.
____________________________________________________________________
___________________________________________________________________

Additional Information
Based on your observations of the strengths and weaknesses of this candidate
please give any other information relevant to the position application.
Hanan does not need a lot of supervision and is always keen to learn and develop
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________

Are you aware of any disciplinary proceedings against candidate? NO YES

If you answered YES to above question please give details below:

___________________________________________________________________
___________________________________________________________________

Would you happily re-employ the named candidate? NO YES

If you answered NO, please give details below:

___________________________________________________________________
___________________________________________________________________

Please state reason for Leaving?


She moved on to a different employer
___________________________________________________________________
___________________________________________________________________

The answers given above have been provided in good faith and are correct to the best of my
knowledge and belief.

REFEREE NAME: Linda Chikumira


ORGANISATION: TXM
POSITION: Senior staff nurse
TELEPHONE NUMBER: 07960980843
SIGNATURE AND DATE: 13/05/2026

Please copy workplace stamp here


I am not at work this week so cant put a stamp but you did send refference to my wirk email. I am
now with HCA International group of hospitals.

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