Welcome to the Careers Application Form

Thank you for your interest in helping us bring confident, independent movement to our community. Please complete the application below.

Personal Info

First Name *

Last Name *

Email *

Phone *

Preferred Contact Method *

Email

Phone

Text

Position & Availability

Position Applying For *

Desired Start Date

Availability

Weekdays

Evenings

Weekends

Flexible

Experience & Education

Licenses / Certifications *

Years of Experience

Relevant Skills / Specialties

Resume Upload *

file upload: PDF, DOC, DOCX

PDF, DOCX or DOC

Optional Questions

Why do you want to work with Form & Focus Rehab?

Do you have reliable transportation for mobile visits?

Are you comfortable traveling within Grosse Pointe and Saint Clair Shores, MI?

By checking this box, I consent to a background check if offered employment

By checking this box, I give permission for Form & Focus Rehab to contact my references

Click the button below to submit your information and we’ll reach out soon

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