Application for Employment

Please fill out the application form below, and a HealthCare Talent recruiter will contact you to discuss positions that fit with your career goals.

  • Personal Information


























  • Phone Numbers

  • Emergency Contact







  • Your Qualifications













  • Computer Skills

    Select your level of proficiency in each

  • Add a new row
  • Education

    Most recent school first
  • Employment History

    Most recent employment first





















  • License or Certifications

  • Include details of conviction, offense, location, date, and sentence.
  • such as specialized training, certifications, recent continuing education courses, additional work experience, etc...
  • Professional References

    Please only list people that we may contact




























  • Security Release

    I certify that the information provided herein is correct and complete. I authorize HealthCare Talent, Inc. or its designated representative, to investigate and verify any of the information bearing on my employability and to use this information in connection therewith. I authorize and request any and all persons including, without limitation, employers, former employers, references, schools, credit agencies, law enforcement agencies, other government agencies and any other person who may have information relative to my abilities, business activities, police record, educational history, etc., to disclose all information to HealthCare Talent or its representatives, and I release HealthCare Talent, representatives, employers, former employers, references, school, agency and persons and their successors or assigns from any and all liability of whatever nature arising from the investigation into my background by reason of furnishing such information to HealthCare Talent or its representative.

    I understand that any misrepresentation (by omission or concealment or by false, misleading or partial answers) may result in the withdrawal of work opportunities or the cancellation of any explicit or implied obligations.

    I understand that the offer of work opportunities with HealthCare Talent is contingent upon satisfactory completion of any investigation which may undertake or direct concerning myself or any information furnished in connection with my candidacy for employment.

  • Confidentiality Agreement

    In the event that I am hired by HealthCare Talent, I will not directly or indirectly disclose, use, or take either during or after my employment any property of HealthCare Talent and their assigned Clients or confidential or proprietary information of HealthCare Talent and their assigned clients including but not limited to records, data, or information regarding clients, employees, business, finances, operations, or related information. I also agree to deliver promptly (on request or on the date of termination of my employment) all documents, copies thereof, and other materials relating to any confidential or proprietary information that are the property of HealthCare Talent, and their assigned clients.

  • Agreed Upon Conditions of Employment

    I understand that my employment by HealthCare Talent is at will, meaning that either HealthCare Talent or I can terminate the employment relationship at any time for any lawful reason with or without notice. I acknowledge that any false, incomplete, or misleading information that I provide on this application form, in a resume, or in a pre-employment interview will be grounds to deny my application or, if discovered later, for immediate dismissal from employment.

    I also understand and agree that subject to applicable state laws, the company reserves the right to conduct a criminal background check any time during employment and as a pre-employment requirement. Any violation not disclosed shall result in an applicant not being hired or an adverse employment action up to and including immediate termination. HealthCare Talent has the right to change this policy at any time as it requires.

    Subject to applicable state laws, the company reserves the right to conduct drug screening and testing for reasonable suspicion at any time during employment and as a pre-employment requirement. Any violation of this policy shall result in an applicant not being hired or an adverse employment action up to and including immediate termination. HealthCare Talent has the right to change this policy at any time as it requires.


 

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