Axon Neuro partners

Join Axon Neuro as a rehabilitation assistant

Complete this application and attach your photo and documents. It takes around 15 minutes. Our team will review it and be in touch. Your information is kept securely and used only to assess and set up your account.

Your details

First name *Last name *Email *Phone *Date of birth *Postcode *

Home address *Town / area shown to clients

Right to work and tax

National Insurance number *Self-employed UTR *Trading status

DBS and safeguarding

DBS certificate number *DBS issue date *

I am registered with the DBS Update ServiceI am cleared to work with vulnerable adults

About you

Experience (e.g. years, level)Languages spoken

Short bio (shown to clients)

I drive and have my own vehicle

Rate and availability

Your hourly rate (GBP) *Your unsociable-hours rate (optional)Max travel distance (miles) *Minimum booking length (hours, optional)Insurance expiry date *

Days and times you are available *

Documents

Photo up to 5MB; documents up to 10MB each. Images or PDF.

Photo of yourselfPhoto ID (passport or driving licence) *Proof of right to work in the UK *Proof of address *Enhanced DBS certificate *Insurance certificate (Public Liability / Professional Indemnity) *CV *Reference (optional)Qualification certificate (optional)First aid certificate (optional)

Consent

I consent to Axon Neuro processing the information and documents in this form to assess and set up my account, in line with the privacy notice.I confirm the information I have given is accurate.