You are applying for
Wake Night Support Worker

Yes No

British Passport British Birth Certificate Visa - Settled Status Visa - Dependent Visa - Student Visa - Post-Graduate Visa - Sponsored by another employer None

Yes No Not applicable

Yes No

Yes No

Yes No

Yes No

Children Clinically Complex e.g. Trachy support Learning Disabilities Autism Acquired Brain Injuries Spinal Injuries Clinical mental health e.g. Schizophrenia, Personality Disorder etc. None of the above

Personal Care PEG feeding or similar Medication Administration Tracheostomy Care including suctioning PBS - Positive Behaviour Support Mental health needs Self-harm e.g. Ligature, head-banging, ingesting Behaviours that can be perceived as challenging Epilepsy Bowel care Catheter care Oxygen therapies e.g. nebulisers and ventilation None of the above