Independence Assistance Employment Application

We are currently accepting applications for compassionate, dependable caregivers, CNAs, and home aides for full time and part time positions who are interested in providing in-home, non-medical care to our clients in Lexington and surrounding counties.


Independence Assistance seeks quality, caring and dependable caregivers who can pass a criminal and motor vehicle background check and drug screening. We provide an in-house training program prior to caring for clients.


If you believe you would make an exceptional caregiver, we would like to hear from you!


How to Apply


Click here to download an employment application or apply here using the fields below.


If printing an application and completing by hand, please fax to 859-317-9924, mail or deliver your application to:


Independence Assistance
343 Waller Avenue, Suite 305
Lexington, KY 40504


Independence Assistance is an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including race, color, age, sex, religion, disability, medical condition, national origin, or marital status.

Your Information

Emergency Contact

Have you ever been convicted of a felony?:


Many caregiver positions require the caregiver to transport a client. Do you have dependable transportation?

Do you have insurance?


How reliable are you? What is your attendance record at your current/last place of employment?

Can you be called at the last minute in case of an emergency?



Did you graduate?


Discuss any training or experience working with the elderly:

What would you like most about working with the elderly?

What would you like least about working with the elderly?

What qualities do you have that make you a good candidate for this position with our company?


Please indicate whether you have assisted with or performed the following tasks for seniors:
Bathing/DressingBed Linen ChangesClean BathroomsClean KitchenCompanionshipCookingDrivingDustingGrocery ShoppingGroomingIncontinenceLaundryMedication RemindersTransfer AssistVacuuming

Physical Ability

Are you able to lift and place a folder wheelchair into a car?

Do you have the ability to lift 25 pounds?

Can you stand for extended periods of time?


Employment History

Please go back at least five years and tell us about your work history.

May we contact your current employer?

Company 2:

Company 3:

Company 4:

Business References

Please list 2 references with Name, Phone Number, Address & Years Known. Please do not list relatives.

Personal References

Please list 3 references with Name, Phone Number, Address & Years Known. Please do not list relatives.

Certification & Release: Signature


We’d love to have you join the Independent Assistance team! Submit your resume here.

Our Office

343 Waller Ave. Suite #305

Lexington, KY 40504


Phone: 859.303.4040

Office Hours

Monday thru Friday
8AM to 5PM EST

Service Hours

24 hours a day

7 days a week

If you have any questions, please don’t hesitate to contact us.