Never have been shown by credible evidence (e.g. a court or jury, a department investigation, or other reliable evidence) to have abused, neglected, sexually assaulted, exploited, or deprived any person or to have subjected any person to serious injury as a result of intentional or grossly negligent misconduct as evidenced by an oral or written statement to this effect obtained at the time of application;
I acknowledge that I have received and read the Misconduct or abuse statement form and that I understand its contents.
If applying online: Please be advised that
THIS AUTHORIZATION AND ATTESTATION PAGE WILL NEED YOUR HANDWRITTEN SIGNATURE AND DATE
I authorize Metnurse to contact each former employer, firm or corporation and the release of information concerning my credentials and job history. I authorize any of these persons to give all information concerning work-related items and I release all parties from liability for any damage that may result from furnishing same to you.
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed; falsified statements on this application shall be grounds for dismissal.
I also understand that if accepted by the Metnurse, my employment is voluntarily entered into and I am free to resign at any time upon two weeks notice. Similarly, Metnurse is free to terminate my employment at any time. I further recognize that this application is not a contract and cannot create a contract.
I also understand that I am required to carry my own Professional Liability Insurance.
I also understand that my employment will continue to be either a Part-Time or PRN Position for 90 Days and on active schedule to be considered an employee of Metnurse Health Services, Inc. DBA (MHS). I also understand that I must give Two Week Notice prior to leaving any assigned case.
