Physiotherapy physiotherapy Please Fill this Form Clearly1) Personal PhotographAccepted file types: jpg, jpeg, png, gif.2) Full Name 3) Date of application DD slash MM slash YYYY Address 4) Phone Number5) Email 6) Sex Male Female 7) National status 8) Age 9) Nationality Educational Data10) Last earned CertificatesYear PassedUniversity / School / InstituteMajorsCertificates Add Remove11) Degree 12) Languages Add Remove13) Do you have experience in physiotherapy? Yes No 14) Have you worked before? Yes No Patient's CaseDuration of workAddress of the patient (city) Add Remove15) Have you previously worked at a hospital / clinic / organization Previous workNumber of years Add RemoveAdditional Information16) Do you have health problems? Yes No Specify 17) Do you drive? Yes No 18) Do you Smoke Yes No 19) Preferred salary currency Lebanese Lira L.B.P US Dollar $ 20) Preferred patient age Child / Newborn Adult Patient Both 21) The area you prefer to work in Specific City Any City Specify which city 22) Time of work you prefer Any time Specific time Specify 23) Your Activities Add Remove24) Your Skills Add Remove25) Your Objectives Add RemoveConsent I hereby declare that the information mentioned above is accurate and complete. I pledge to abide by the instructions and regulations, to be diligent in my work, and to be mindful of the administration’s reputation and the well-being of the patient. I also commit to maintaining a direct relationship with the owner of the establishment, rather than their family, and to approach the owner in case of any issues. I pledge not to disclose any work-related secrets to the family.Certifications Drop files here or Select files Max. file size: 256 MB. Permission to practice the professionMax. file size: 256 MB.
