Community Health Worker Employment Verification Form

Community Health Worker Employment Verification Made Simple

Verifying employment for community health workers requires more than basic job confirmation—it demands detailed documentation of certifications, caseloads, home visit metrics, and patient navigation outcomes. This Community Health Worker Employment Verification Form streamlines the entire verification process for healthcare organizations, public health departments, hiring managers, and credentialing teams.

Whether you're conducting background checks for new hires, verifying credentials for grant applications, or documenting performance metrics for funding requirements, this template captures all essential information in one organized, professional form.

Built for Healthcare Hiring and Credentialing

Community health workers play a vital role in connecting underserved populations with healthcare services, conducting home visits, and navigating complex health systems. This form template is specifically designed for:

• Healthcare HR departments verifying employment history for new community health worker candidates
• Public health agencies documenting CHW performance and outcomes for reporting requirements
• Grant administrators collecting verification data for federally funded community health programs
• Insurance credentialing teams validating CHW qualifications and work history
• Background screening companies gathering comprehensive employment verification for healthcare positions

The form captures certification status (including state-specific CHW credentials), detailed work history, home visit volume metrics, patient navigation outcomes, and supervisor contact information—all the data points required for thorough employment verification in community health settings.

Streamline with Paperform's Healthcare-Friendly Features

Built on Paperform's intuitive platform, this template offers immediate benefits for healthcare organizations:

Conditional logic reveals relevant follow-up questions based on certification type and employment status, keeping the form concise while capturing detailed information when needed. File upload fields let applicants attach certification documents, performance reviews, or outcome reports directly within the form submission.

Professional design with healthcare-appropriate styling creates a trustworthy experience that reflects well on your organization. Forms can be customized with your health system's branding, embedded on your careers or credentialing pages, or shared as standalone verification portals.

For organizations managing multiple verifications simultaneously, connect this form to your HIPAA-compliant systems via Stepper (stepper.io) to automatically route submissions to the right department, update your ATS or HRIS, notify hiring managers when verifications are complete, and maintain audit trails for compliance documentation.

AI Insights can analyze submission patterns across multiple verifications, helping you identify credential gaps, common employment histories, or areas where additional training might be needed across your CHW workforce.

Secure, Compliant, and Ready to Deploy

Employment verification involves sensitive personal and professional information. Paperform provides SOC 2 Type II compliance, SSL encryption, and robust data handling to protect applicant information throughout the verification process. Set up role-based access so only authorized HR or credentialing staff can view completed verifications, and use conditional confirmation messages to set clear expectations about verification timelines.

Whether you're a county health department, a Federally Qualified Health Center (FQHC), a community-based organization, or a healthcare staffing agency, this template gives you a professional, comprehensive solution for community health worker employment verification—no technical expertise required.