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We are an Equal Opportunity Employer

Experience Relative To Desired Position

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Applicant Note: This application form is for use in evaluating your suitability for employment. It is not an employment contract. Please answer all appropriate questions completely and to the best of your ability. False or misleading statements are grounds for refusal or termination of employment and benefits. Federal law provides penalties for false statements on documents related to U.S. employment eligibility. The company reserves the right to determine an applicant's eligibility for employment or termination of employment while governed by state and federal statutes regarding equality without discrimination of sex, creed, race, natural origin, religious preference or disability. Reasonable accommodation may be available to persons otherwise able to fulfill job responsibilities. Testing for the presence of illegal drugs and/or alcohol is required before employment. All unlicensed persons with face-to-face contact with clients will have pre employment and annual EMR/NAR check.

I certify that I have not been excluded from Medicare, Medicaid, and/or any other federally funded healthcare program.

Certification and Release: I certify that I have read and understand the Applicant Note found above and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts called for in this application may result in rejection of my application or discharge at any time during my employment. I authorize the company and its agents, including consumer reporting bureaus, to verify any of this information including, but not limited to, criminal history and motor vehicle records. I release all persons, schools, companies and law enforcement authorities from from any liabilities for any damage whatsoever for issuing this information. I also understand that the use of illegal drugs is prohibited during employment. I am willing to submit to drug testing to detect the use of illegal drugs before and during employment. Illegal drugs means any drug which is not legally obtainable or which is legally obtainable but has not been legally acquired or administered. This agency will not hire, continue to employee anyone who is under a sanction or has been excluded from Medicare, Medicaid or other federally funded health care programs.