documents_type][]=$document->path.$document->file_name; $documentsrem[$document->documents_type][]=$document->remarks; $documentsid[$document->documents_type][]=$document->id; $documentsno[$document->documents_type][]=$document->documents_no; //echo '
'; print_r($document); echo '
'; } $traing_doc_count=count($documentsarr[_DOC_TRAININGCODE_]); $other_doc_count=count($documentsarr[_DOC_OTHERCODE_]); $additional_certificate_count=count($documentsarr[_ADDL_CERTIFICATE_]); ?> session->flashdata('feedback_error')){ ?> session->flashdata('feedback_success')){ ?>

Caregiver Information

Caregiver Id : fname;?> lname; ?>
Name : fname;?> lname; ?>
D.O.B : fname;?> lname; ?>
Caregiver Type : fname;?> lname; ?>
Telephone : fname;?> lname; ?>
Address : fname;?> lname; ?>
Eye Color : fname;?> lname; ?>
Hair Color : fname;?> lname; ?>
Height & Weight : fname;?> lname; ?>
Language (s) : fname;?> lname; ?>
Employee Type : fname;?> lname; ?>
Hire Date : fname;?> lname; ?>

citizen); ?>
citizen) && $citizen->citizen==1) { echo "checked"; } ?>>
citizen) && $citizen->citizen==0) { echo "checked"; } ?>>
citizen)){ echo ''; }else if($citizen->citizen==0){ echo ''; }else{ echo 'style="display: none;"'; } ?>>
remain_permanently) && $citizen->remain_permanently==1) { echo "checked"; } ?>>
remain_permanently) && $citizen->remain_permanently==0) { echo "checked"; } ?>>
remain_permanently)){ echo ''; }else if($citizen->remain_permanently==0){ echo ''; }else{echo 'style="display: none;"'; } ?>
remain_permanently)||($citizen->remain_permanently==1)){echo 'style="display: none;"'; } ?>>
authorization_to_work) && $citizen->authorization_to_work==1) { echo "checked"; } ?>>
authorization_to_work) && $citizen->authorization_to_work==0) { echo "checked"; } ?>>
involved_as_defendant) && $citizen->involved_as_defendant==1) { echo "checked"; } ?> required>
involved_as_defendant) && $citizen->involved_as_defendant==0) { echo "checked"; } ?> required>
involved_as_defendant)) || ($citizen->involved_as_defendant==0)){ echo 'style="display:none;"'; } ?>>
convicted) && $citizen->convicted==1) { echo "checked"; } ?> required>
convicted) && $citizen->convicted==0) { echo "checked"; } ?> required>
convicted)) || ($citizen->convicted==0)){ echo 'style="display:none;"'; } ?>>
convicted_for_negligence) && $citizen->convicted_for_negligence==1) { echo "checked"; } ?> required>
convicted_for_negligence) && $citizen->convicted_for_negligence==0) { echo "checked"; } ?> required>
convicted_for_negligence)) || ($citizen->convicted_for_negligence==0)){ echo 'style="display:none;"'; } ?>>
criminal_convictions) && $citizen->criminal_convictions==1) { echo "checked"; } ?> required>
criminal_convictions) && $citizen->criminal_convictions==0) { echo "checked"; } ?> required>
criminal_convictions ==0 ) {?> style="display:none" >

Height & Weight : Palta Ambagan Road
Language (s) : Palta Ambagan Road
Employee Type : Palta Ambagan Road
Hire Date : Palta Ambagan Road

School Name Location of School Degree/Certification Graduation Date
ABC ABC fname.''.$nurse->lname; ?> 23-09-2015
ABC ABC fname.''.$nurse->lname; ?> 02-09-2014
ABC ABC fname.''.$nurse->lname; ?> 23-09-2015

verification->npi_no)) { echo $nurse->verification->npi_no; } ?>' minlength="10" maxlength="10" placeholder="" onkeypress="return isNumberKey(event)" required data-error="Please enter npi.">

verification->malpractice_comp_name)) { echo $nurse->verification->malpractice_comp_name; } ?>' placeholder="" required data-error="Please enter Malpractice Insurance Policy.">

hb_form); //pr($nurse);die; ?>

I fname." ".$nurse->mid_name." ".$nurse->lname ?> , have been informed of the complication / side effects of receiving Hepatitis B vaccine and I choose to have the vaccine administered to me.

incident_report==1) { echo "checked"; } ?>>
incident_report==0) { echo "checked"; } ?>>
report_completed==1) { echo "checked"; } ?>>
report_completed==0) { echo "checked"; } ?>>
Hepatitis B Vaccine TYPE DATE DOSE SITE
Initial Dose
Second Dose
Third Dose
Booster Dose
DATE TYPE RESULTS ACTION TAKEN
Field Data Action
Basic Info
Name fname.''.$nurse->lname; ?>
Mobile Number phone; ?>
Email email; ?>
Qualification type qualification; ?>
Total years of experience years_of_exp; ?>
Personal Info
Gender gender; ?>
Marital Status marital_status; ?>
Dependents dependents; ?>
Date of Birth dob; ?>
Soc Sec soc_sec; ?>
Country of Birth country_of_birth; ?>
Ethnicity ethnicity; ?>
Height (feet/inches) height; ?>
Weight () weight; ?>
Eye Color eye_color; ?>
Hair Color hair_color; ?>
Primary Languages Spoke primary_langualge; ?>
Contact Info
Permanent Address address1.','.$nurse->direction1.','.$nurse->state1_name.','.$nurse->county1.','.$nurse->zipcode1; ?>
State Verification state1_name; ?>
Alternate Mailing Address address2.','.$nurse->direction2.','.$nurse->state2_name.','.$nurse->county2.','.$nurse->zipcode2; ?>
Alternative Mobile No. phone2; ?>
Other Contact other_contact; ?>
Alternative Email alternative_email; ?>
Preferred Contact Method preferred_contact; ?>
Basic Documents
School Certificate Verification
Photo View
Citizen Documentation View
Social Security Card View
State or Federal issued ID View
Malpractice Insurance Policy View
Resume View
NPI Document View
Medical Documents
Annual Employee Health View
Drug Screen View
Flu Vaccine View
Covid Report View
CPR Report View
Licenses & Certifications
Licence View
Aditional Documents View
Other Documents
Documents Details View
Employment Info
Availability(Borough) avail_borough; ?>
Availability(Time Slot) avail_time_slot; ?>
Availability(Stay) availability_stay; ?>
Application Date application_date; ?>
Pre Employment Skill Competency pre_emp_skill; ?>
PCA Registry Number PCA_Registry_Number; ?>
Reference
Personal References Name Personal_References_Name; ?>
Personal References Address Personal_References_Address; ?>
Personal References Telephone Personal_References_Telephone; ?>
Profesonal References Name Profesonal_References_Name; ?>
Profesonal References Address Profesonal_References_Address; ?>
Profesonal References Telephone Profesonal_References_Telephone; ?>
Additional Certifications
Additional Certificate Details View
Emergency Contact
Name Emergency_Contact_Name; ?>
Relationship Emergency_Contact_Relationship; ?>
Address Emergency_Contact_Address); echo $x->Emergency_Contact_Address.','. $x->Emergency_Contact_zipcode; ?>
Telephone Emergency_Contact_Telephone; ?>
Cellphone Emergency_Contact_Cellphone; ?>
Other Emergency_Contact_Other; ?>
Email Emergency_Contact_Email; ?>
Lives with patient live_with_patient; ?>
Have Keys or access to home have_key; ?>
Caregiver Preference
Preffered Gender Preffered_Gender; ?>
Notes Notes; ?>
Accept