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EMPLOYMENT APPLICATION
Position of Interest
Mobility Transportation Specialist (MTS)
Stretcher Transportation Specialist (STS)
Dispatcher
Administrative Assistant
Other:
Applicant Information
Employment Eligibility
Are you legally authorized to work in the United States?
Yes
No
Will you now or in the future require sponsorship?
Yes
No
Position Availability
Full-Time
Part-Time
Per Diem
Availability:
Days
Evenings
Weekends
Holidays
Driving Experience
Vehicle Experience
Ambulette
Wheelchair Accessible Vehicle
Stretcher Vehicle
Passenger Van
Commercial Vehicle
License & Compliance History
Have you ever had your driver's license suspended?
Yes
No
Have you received moving violations within the last 3 years?
Yes
No
Have you ever been convicted of a felony?
Yes
No
Training & Certifications
CPR Certified
First Aid Certified
Defensive Driving
Passenger Assistance Training
Wheelchair Securement Training
Stretcher Transport Training
HIPAA Awareness Training
NEMT Experience
Employment History
Emergency Contact
References
Reference #1
Reference #2
Truepath Driver Training Pathway
Core Training Requirements:
Medical Transport Driver Course (MTDC) – Equivalent to NEMTAC CTS
NEMT 4 3-D Driver Safety Training
AHA Heartsaver First Aid, CPR & AED
After completion of core training:
Mobility Transport Specialist (Wheelchair Track)
Stretcher Transport Specialist (Stretcher Track)
Truepath covers all required training costs for qualified employees.
Applicant Certification
I certify that all information provided is true and complete to the best of my knowledge.
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