Step 3 · Documents & Health Requirements

Payroll Forms, Health Screening & Required Documents

This step collects your federal payroll forms (W-4/W-9, I-9), required health screenings (TB, communicable disease, Hepatitis B declination), and your core onboarding documents for Saintly Home Health.

You can complete these sections in any order. If you’re missing something, you can come back to this page later and submit the remaining forms.

Back to Application Start with Payroll Forms

Compliance Checklist

W-4 or W-9 · I-9 · TB screening & test · Communicable disease statement · Hep B declination (if applicable) · ID, license, CPR, fingerprint card & more.

Onboarding Progress Step 3 of 6 · Documents & Health Requirements
  1. 1
    Welcome
    Overview
  2. 2
    Application
    Job details
  3. 3
    Documents
    Payroll & health
  4. 4
    Contracts
    Offers & IC
  5. 5
    Training
    Required modules
  6. 6
    Complete
    Final review
Step 3 · Payroll & Employment Eligibility
Upload Required Federal Forms
Please complete the official IRS and USCIS forms below. Download, fill out, and sign the PDF that applies to you, then upload your completed copy so Saintly Home Health can place it in your personnel file.
Employees

Form W-4 – Employee’s Withholding Certificate

If you are being hired as an employee, complete the official IRS Form W-4 so we can withhold the correct federal income tax from your pay.

Download W-4 PDF
Independent Contractors

Form W-9 – Request for Taxpayer Identification Number

If you are working with Saintly Home Health as an independent contractor, complete Form W-9 so we can issue accurate 1099s for your services.

Download W-9 PDF
Employment Eligibility

Form I-9 – Employment Eligibility Verification (Section 1)

All employees must complete Section 1 of the official USCIS Form I-9 no later than the first day of work. Saintly Home Health will complete Section 2 in person after reviewing your original identity and work-authorization documents.

Download I-9 PDF
These sections are provided for convenience and do not replace the official IRS and USCIS instructions that accompany each form. Please review the full instructions in the PDF before signing.
Step 3 · Health & Safety Forms
Health Screening, TB Risk & Hepatitis B
Complete the health and safety forms below. These reflect the same content as the Saintly Home Health paper forms so they can be completed and signed fully online.
Use the same name and email on all forms so the office can match your onboarding records.
A — Free of Communicable Disease
Free of Communicable Disease Statement
This form documents that you are free from any communicable disease that would interfere with safe performance of your duties or pose a risk to patients, families, or coworkers.
By signing, I attest that this statement is accurate and understand that I must notify Saintly Home Health if my health status changes in a way that may pose a risk to patients or coworkers.
B — TB Questionnaire & Risk
TB Targeted Medical Questionnaire & Risk Assessment
This form mirrors the Saintly TB Targeted Medical Questionnaire and Risk Form. Answer each item based on your history and current health. Upload your TB test result performed within 10 days of your hire date.
Should match the date shown on the TB test result you upload below.
Upload a clear image or PDF of your TB test (PPD/TST reading or Quantiferon Gold) showing the test date and result. Must be dated within 10 days of your hire date.
Persistent cough longer than 3 weeks
Coughing up blood
Unexplained weight loss
Night sweats or prolonged fever
Unusual fatigue or weakness
None of the above
By signing, I attest that the answers above are true and complete to the best of my knowledge, and that the TB test result I have uploaded is dated within 10 days of my hire date. I understand this information will be used to determine my TB screening and clearance for employment.
C — Hepatitis B (Contractors)
Contractor Hepatitis B Vaccine Declination
This section mirrors the Saintly Contractor Hepatitis B Vaccine Declination form. It is used when a contractor with potential occupational exposure to blood or body fluids chooses to decline vaccination.
I understand that, because my work with Saintly Home Health may involve contact with blood or other potentially infectious materials, I may be at risk of acquiring Hepatitis B virus (HBV) infection. I have been given the opportunity to be vaccinated against Hepatitis B at my own expense or in accordance with my contractual agreement. However, I decline the Hepatitis B vaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring Hepatitis B infection. If, in the future, I choose to accept vaccination, I may request it and arrange for vaccination at that time.
Note: Employees (non-contractors) who are offered Hepatitis B vaccination through their employer should follow their employer’s vaccination and declination process.
Step 3 · Document Uploads
Employee Document Upload Center
Upload clear, readable copies of all required documents below.
Make sure your photos are clear. Blurry or cropped photos will delay onboarding.
Personal & Identification Documents
Required if you will be driving to see patients in the community.
Arizona Fingerprint Clearance Card
Upload both front and back. Arizona requires a valid Fingerprint Clearance Card for most staff.
📌 Need a fingerprint card? Apply here → Arizona DPS Fingerprint Clearance Card
Licensure & Clinical Documents
Professional Liability Insurance (Independent Contractors)
If you are not an IC, you can leave this blank.
The office will review and confirm your submission.