The information provided in this application is true and correct to the best of my knowledge. I understand that, in the event of my employment by Heritage Health Services, I shall be subject to dismissal if any information that I have given in this application is false or misleading, of if I have failed to give any information herein requested, regardless of the time elapsed after discovery.

I authorize Heritage Health Services to inquire into my educational, professional and past employment history references as needed to research my qualifications for this position. I hereby give my consent to any former employer to provide employment related information about me to Heritage Health Services and will not hold Heritage Health Services or my former employer responsible for any claim made on the basis that such information about me was provided or that any employment decision was made on the basis of such information. I further authorize Heritage Health Services to obtain any credit and consumer check.

I understand that nothing in this employment application, the granting of an interview or my subsequent employment with Heritage Health Services is intended to create an employment contract between myself and Heritage Health Services under which my employment could be terminated only for cause. On the contrary, I understand and agree that, if hired, my employment with Heritage Health Services will be terminable at will and may be terminated by myself of Heritage Health Services and anytime and for any reason. I understand that no person has any authority to enter into any agreement contract to the foregoing.

If employed, I will be required to provide original documents which verify my identity and right to work in the United States under the Immigration Reform and Control Act (IRCA) of 1986. The document(s) provided will be used for completion of Form I-9.

All applicants will be subject to background checks and/or screenings as required by applicable state and federal laws as well as facility policy. Heritage Health SErvices is committed to a plicy of equal employment opportunity and considers all persons without regard to race, color, religion, age, gender, national origin, disability, marital status, vertarn's status, or any other legally protected classification as defined by city, state and federal laws.