Clinical Care Director

UPLOAD YOUR RESUME*

UPLOAD A COVER LETTER (OPTIONAL)

EMPLOYMENT DESIRED*

FULL-TIMEPART-TIMEEITHER

CAN YOU WORK NIGHTS?*

YESNO

ARE YOU 18 OR OLDER?*

YESNO

I certify that I am a U.S. citizen, permanent resident, or a foreign national with authorization to work in the U.S.

YESNO

Have you ever been convicted of a felony?*

YESNO

Disclosure

I understand the Immigration Reform Act of 1986 requires that, if hired, I must present on my first day of employment, but no later than 3 days from my first day of employment, documents to verify my legal right to work in the United States.

I hereby certify that all information provided here by me and on the attached resume is true and correct, and I understand that giving false or misleading information may result in the refusal to hire me or in subsequent termination in my employment.

I understand if salaried, my salary commitment is based on a yearly salary schedule. I will comply with the policies and procedures of Agapé Hospice.

I understand the number of hours I will be required to work may vary from week to week. I also understand that I may be required to work different shifts as needed.

I authorize persons, companies, schools and colleges shown on my employment application to give any information regarding my employment and academic records, together with any information they may have regarding me whether or not it is in their records. I hereby release said companies, schools or persons from any liability for any damage whatsoever for issuing this information.

I understand that an offer of employment to work at Agapé Hospice is contingent upon the completion of a successful background check, a clean drug screen, and other necessary screens as required.

By submitting application, I certify I have never been sanctioned by a government body related to healthcare, convicted of a criminal offense related to healthcare, or listed by a federal agency as debarred, excluded, or otherwise ineligible for participation in a federal funded healthcare program.

I understand, if hired, I will be required to hold Agapé Hospice’s confidential and / or proprietary information and any information concerning patients of Agapé Hospice confidential and will not disclose it to any person or entity not affiliated with Agapé Hospice throughout my employment and therafter.

I understand, if hired, my employment will be at-will and that my employment and compensation can be terminated with or without cause, and with or without notice at any time, at the option of either Agapé Hospice or myself. By submitting this application I affirm my awareness that this is the final understanding between myself and Agapé Hospice on the subject and there can be no modification or agreement contrary to at-will provisions, unless in writing and signed by both parties.

I have read and accept the disclosure information.

Disclosure

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