Applicant Interest Survey Applicant Interest Survey Name Date GMS serves many individuals with different strengths, interests and personalities who also require varying types and levels of support. The following questions are designed to aid GMS in determining which home or program may be the most suitable match for you if employed by GMS. Please answer honestly as appropriate placement may be a significant factor in the success of consumer treatment and your job satisfaction. 1. Have you worked in a Program where you provided personal care assistance to consumers such as toileting, bathing, dressing, feeding, and changing depends? Yes No 1a. Will you work in a Program where you must provide personal care assistance to consumers such as toileting, bathing, dressing, feeding, and changing depends? Yes No 2. Have you worked with Deaf and/or non-verbal consumers? Yes No 2a. Will you work with consumers who are deaf and/or non-verbal? Yes No 3. Have you worked with consumers who have aggressive, threatening or self-injurious behaviors? Yes No 3a. Will you work with consumers who have aggressive, threatening or self-injurious behaviors? Yes No 4. Have you worked with consumers who have mental health issues? Yes No 4a. Will you work with consumers who have mental health issues? Yes No 5. Will you work with both male and female consumers? Yes No, Please Explain Additional information: Submit Δ
