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First Name:
Last Name:
Nick Name:
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Age:
Distance willing to travel for work:
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1 mile
2 miles
3 miles
4 miles
5 miles
6 miles
7 miles
8 miles
9 miles
10 miles
15 miles
Do you smoke?
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Will work with:
Male
Female
Both
Experience with Alzheimer's disease and Dementia:
Yes
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Able to use transfer equipment:
Hoyer Lift
Gait Belt
Transfer Board
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