Please read each statement carefully before signing
I certify that all information provided in the employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date.
I authorize and agree to cooperate in a thorough investigation of all statements made herein and other matters relating to my background and qualifications. I understand that any investigation conducted may include a request for employment and educational history, credit reports, consumer reports, investigative consumer reports, driving record and criminal history. I authorize any person, school, currand former employer, consumer reporting agency, and any other organization or agency to provide information relevant to such investigation and I hereby release all persons and corporations requesting or supplying information pursuant to such investigation from all liability or responsibility to me for doing so. I understand that I have the right to make a written request within a reasonable period of time for complete disclosure of the nature and scope of any investigation. I further authorize any physician or hospital to release any information which may be necessary to determine my ability to perform the job for which I am being considered or any future job in the event that I am hired.
I understand that compliance with the Company's Policies & Procedures is a condition of my employment.
I understand that I must successfully pass both drug and criminal background screenings. I hereby consent to these screenings as a condition of my employment.
I understand that in accordance with the Collom & Carney Compliance Plan, the clinic will conduct appropriate screening to verify that I have not had any sanctions imposed on me by Federal or State Law Enforcement, Regulatory, or licensing agency for either conduct or performance based action.
I understand that this application or subsequent employment does not create a contract of employment nor guarantee employment for any definite of time. If employed, I understand that I have been hired at the will of the employer and my employment may be terminated at any time with or without cause and with or without notice.
I have read, understand, and by my signature consent to these statements.