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C. §708). The hospital requests a newly hired applicant’s present or former employer to provide service dates, business details, and answers about the type of service performed, separation reasons, and performance-related statements for employment or licensure purposes. Includes authorization and release acknowledgment, plus internal receipt fields.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":41,"@type":70,"position":76},"https://docshare.wps.com/template/letters/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/saint-francis-hospital-service-letter-request-form/276397/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/saint-francis-hospital-service-letter-request-form/276397.png","ImageObject",442,249,{"name":88,"@type":89},"Berry Peter","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-31","2026-09-15",true,{"@type":98,"interactionType":99,"userInteractionCount":15},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What is the purpose of the Service Letter request from Saint Francis Hospital?","Question",{"text":108,"@type":109},"It helps Saint Francis determine whether an applicant meets employment requirements by collecting truthful information from the applicant’s present or former employer, as required by Delaware law.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What information does the receiving employer need to complete?",{"text":113,"@type":109},"The employer must provide business details, service dates, the type of service performed, reason for separation, and performance-related statements, and it may indicate whether they would rehire the individual.",{"name":115,"@type":106,"acceptedAnswer":116},"Is this form the same as employment verification?",{"text":117,"@type":109},"No. The form is not employment verification; it is a service letter request required by Delaware State Law to be completed by the employer.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},276397,1790498765,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":40,"category_name":41,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":15,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":79,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":73},1374402524268,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Dear Employer,  \nSaint Francis Hospital is a healthcare provider within the State of Delaware. To ensure that the organization remains compliant with Delaware’s Special Employment Practices for Health Care and Child Care Facilities (19 Del. C. §708), Service Letters are requested for all newly hired staff.  \nThis applicant has applied for a position with Saint Francis Healthcare and has given your name as a present or former Employer. To help us determine whether this applicant meets requirements for employment, please complete the attached Service Letter request form and return to us within 7 business days.  \nPlease be advised this is not an Employment Verification and is required by the Delaware State Law to be completed.  \nYour cooperation is greatly appreciated.  \nThank you,  \nSaint Francis Hospital  \nHuman Resources Department  \nType of Business of Employer requesting service letter (Check one):  \n✔ Health Care Facility Child Care Facility  \n Name of applicant:      \n Social Security Number:      \nDates of Employment: From:  To:    \nTO BE COMPLETED BY EMPLOYER RECEIVING SERVICE LETTER REQUEST.  \nThe above-named person has applied for employment/licensure with our organization. The applicant indicated on his/her application that s/he was or is employed by you and has signed an authorization and release form that permits you to truthfully answer these questions without liability.  \n1. Complete Name of Business/Employer:    \nAddress of Business/Employer:    \nType of Business:    \n2. Dates of Service for employee: From:   To:  If this information is not available, please explain:    \n3. Please answer the following questions:  \nA. Type of service performed by the person during the course of his/her employment.  \n(Please Check One.)  \nThe employee was directly involved on a daily or frequent basis providing services and/or care to clients/patients/residents/children.  \nThe employee was not directly involved providing services and/or  \ncare to clients/patients/residents/children on a daily or frequent basis, but did occasionally provide some care and/or services.  \nThe employee did not provide services and/or care to clients/ patients/residents/children, but did have some contact with them.  \nThe employee had no contact with clients/patients/residents/children. This information is not available. (Please Explain.)  \nB. Reason for separation from service (please check one.)  \nLaid-off Resigned Resigned in lieu of discharge  \nDischarged Abandoned Position Other (Specify)   \nInformation not available (Explain)    \nC. Information relating to employee's performance (please check all statements which apply to this person and circle action/s taken.)  \nThe employee was counselled, warned, reprimanded, suspended or discharged as a result of reasonably substantiated incidents involving his/her violent behavior or threats of violence in the workplace.  \nThe employee was counselled, warned, reprimanded, suspended or  \ndischarged as a result of reasonably substantiated incidents involving abuse of patients/clients/residents/children.  \nThe employee was counselled, warned, reprimanded, suspended or discharged as a result of reasonably substantiated incidents involving negligence/neglect of patients/clients/residents/children.  \nThe employee was never counselled, warned, reprimanded, suspended or discharged as a result of reasonably substantiated incidents involving violent behavior in the workplace, abuse or negligence/neglect of patients/clients/residents/children.  \nNot applicable to this employee. (Please Explain.)   4. (Optional) I would rehire this individual yes no  \nI hereby swear/affirm that the information provided above is a full and complete disclosure of the facts required, and that the information is true and correct to the best of my knowledge and belief.  \nPrinted name/title of person completing the form  \nSignature Date  \nThis form is provided by the Delaware Department of Labor. Reproduce additional copies as needed.  \nEmploym","cbCaio7fb1e43rFV","https://ap.wps.com/l/cbCaio7fb1e43rFV","pdf",496593,"English","# Service Letter Request Instructions\n## Employer Completion Section\n## Performance and Separation Questions\n## Optional Rehire and Attestations\n# Employment Application Release and Acknowledgment","[{\"question\":\"What is the purpose of the Service Letter request from Saint Francis Hospital?\",\"answer\":\"It helps Saint Francis determine whether an applicant meets employment requirements by collecting truthful information from the applicant’s present or former employer, as required by Delaware law.\"},{\"question\":\"What information does the receiving employer need to complete?\",\"answer\":\"The employer must provide business details, service dates, the type of service performed, reason for separation, and performance-related statements, and it may indicate whether they would rehire the individual.\"},{\"question\":\"Is this form the same as employment verification?\",\"answer\":\"No. The form is not employment verification; it is a service letter request required by Delaware State Law to be completed by the employer.\"}]","Saint Francis Hospital Service Letter Request Form | PDF",1789492970]