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About us
Our Professional Team
About RYTES
Contact Us
SNFHotline.org
Healthcare Heroes Application
Welcome to your Healthcare Heroes in Action Fund Application
First & Last Name [
Example: John Smith
] :
Mailing Address [
Example: 1 Main St Elmsford, NY 10523
] :
Email Address [
Example: info@rytescompany.com
] :
Which Facility Do You Work In? [
Example: Rytes Rehabilitation Center
]
Have you worked an excess of 175 hours between 4/15/2020 and 5/15/2020?
Yes
No
Please provide the name and phone number of your employer's HR Department
[
Example: John Doe (555) 555-5555
] :
Have you tested positive for COVID-19 anytime after April 15th, 2020?
Yes
No
Are you a direct care provider? (As opposed to a supervisor or a member of management)
Yes
No
I am a(n) __________.
RN
LPN
CNA
Physician Assistant
Licensed Therapist providing direct patient care
Other
If you work as an aide, are you certified? (If you are not an aide, click next)
Yes
No
If you work as a nurse, are you certified? (If you are not a nurse, click next)
Yes
No
Time is Up!
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