Employment Application Agreement

I certify that the facts contained in this application are true and complete to the best of my knowledge.  I understand that any false statements, omissions or misrepresentations on this application or during the employment process, may be considered sufficient cause for rejection of this application or dismissal if I have been employee, no matter when discovered by the company.

I understand that if offered a position, a condition of employment may be that I take a test for the purpose of detecting any drug, which might impair my ability to safely perform my job.  I further understand that should this test indicate the presence of drugs in my body, it may result in the rejection of my application for employment or my immediate discharge, if detected after hire.  I consent to this testing and request that the results of such test(s) be disclosed to the Company and I hereby release the Company, its employees and agents from any and all legal liability flowing from my taking such test(s) as well as my failure or refusal to take such tests.

My signature below provides written consent for this company to release documentation/contents contained within my personnel file to client facilities for the purpose of assignment placement.  I agree to release Company, its personnel, companies or corporations from any or all liability associated with supplying such personnel information.

I understand that my employment is at will and that either party is free to terminate the employment relationship at any time without cause.  I also understand that nothing contained in this application or conveyed during any interview creates or is intended to create an employment contract.   I attest that the information I have provided in this application is the truth.

I hereby agree to hold in strict confidence all confidential and/or proprietary information which I may be exposed to or acquire while working on a client assignment.  Confidential client information that is not generally known to the public or industry at large includes but is not limited to:  client operations, computer records, financial information, patient information and client employee information.

I further agree to keep such information confidential following completion of my assignment with a client.  I acknowledge my obligation to return any and all documentation.  I understand that unauthorized release of any of the above described information whether intentional or through negligence, will be grounds for dismissal by Care IV. I also understand the client could take legal action against me for recovery of damages and injunctive relief.

I agree that I will not seek or accept employment in any capacity from any clients to whom I have been assigned for a period of 90 days after the last day of assignment.

If employed by this company, I will be required to complete an Employment Verification Form (I-9) and within three days show satisfactory evidence of identity and eligibility for employment.

If my availability changes, it is my responsibility to inform Care IV of the changes.  To assure my choice of assignments, I will remember to call Care IV with my availability by Monday of each week.

After completing each assignment with a client, I must contact Care IV to determine whether another assignment is available.  If I fail to contact Care IV, without good cause, I understand that unemployment benefits may be denied.