AUTHORIZATION
I understand that KindHearted Healthcare INC. is making no employment offer at this time. I
certify that the information in this application is correct to the best of my knowledge. I
understand that any misrepresentation or omission of any fact in my application, resume, or
any other materials, or during interviews is grounds for disqualification from further
consideration for employment or for termination if employed. I authorize Kindhearted
Healthcare INC. to contact any company, institution, or individual it deems appropriate to
investigate my employment history, character, qualifications, credit history, driving record,
and other relevant information, if job-related. I give my full consent for all contacted
individuals, including former employers, to provide information concerning this application,
and I waive my right to bring any cause of action against these individuals for any and all
liability for damages arising from furnishing the requested information to Kindhearted
Healthcare INC. I acknowledge that a facsimile and/or photocopy of this form is as valid as the
original. Pre-employment testing may be required (drug testing, background checks, physical
examinations, motor vehicle checks). Testing may be an applicant or employer-paid based
on the employer. I understand that any offer of employment may be withdrawn if drug tests
are positive and/or if a condition is discovered for which no reasonable accommodation can
be made. I understand that this application is current for 60 days. At the conclusion of this
time, if I have not heard from Kindhearted Healthcare INC. and still, wish to be considered for
employment, it will be necessary to complete a new application. I understand that if hired,
employment is at-will, regardless of the employer, and may be terminated by myself or
Kindhearted Healthcare INC. at any time, with or without cause or notice, for any reason or no
reason.
By entering your name, you agree to accept the terms of the above document with an
electronic signature