List all previous employers starting with your present or most recent position (last 10 years is sufficient) below.
I hereby authorize Encompass Medical Group to thoroughly investigate my references, work records, education and other matters related to my suitability for employment and, further, authorize my current and former employers to disclose to the company any and all letters, reports and other information pertaining to my employment with them, without giving me prior notice of such disclosure. In addition, I hereby release Encompass Medical Group, my current and former employers, and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.
I understand that if offered employment, the offer may be contingent on my passing a pre-employment alcohol and drug screen and a pre-employment physical. By signing this application, I voluntarily agree to submit to a pre-employment alcohol/drug screen and pre-employment physical upon request. I understand that failure to pass the alcohol/drug screen and/or physical will result in withdrawal of the employment offer.
If hired, I also agree to submit to alcohol or drug testing as a condition of employment. I agree that Encompass Medical Group may conduct alcohol or drug screening at its sole discretion with or without notice. I also understand that refusal to submit to an alcohol/drug screen will be considered a voluntary resignation of employment.
I understand that nothing contained in the application or conveyed to me during any interview which may be granted is intended to create an employment contract, implied or explicit, between me and Encompass Medical Group. In addition, I understand and agree that if I am employed; my employment relationship with Encompass Medical Group is strictly voluntary and at our mutual will. I understand that if employed, my employment is for no definite period and may be terminated at any time, with or without prior notice, with or without cause or reason, at the option of either myself or Encompass Medical Group, and that no promises or representations contrary to the forgoing are binding on Encompass Medical Group unless made in writing and signed jointly by the President/CEO and myself.
I understand and agree that any future changes in my title, duties, compensation, working conditions, and/or Encompass Medical Group benefits, policies and procedures will not alter our at-will and arbitration agreements.
I understand that if offered employment, I will, as a condition of employment, be required to submit proof of my identity and legal right to work in the United States on my first day of employment.
If the position applied for requires driving in the course of work, I understand that I will be required to possess a current and valid (name of state) driver's license and understand that I will be required to provide a copy of my official driving record and proof of insurance. I also understand that any offer of employment is contingent on my ability to be covered by Encompass Medical Group auto insurance, if required for my position.
I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement on this application or on any documents used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.
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