Employment Application

General Agreement
I understand that all offers of employment are continued on receipt of satisfactory responses to reference requests and the provision of satisfactory proof of an applicant’s identity and legal authority to work in the United States. In consideration of my employment, I agree to conform to the rules and standards of the practice, as amended from time to time at the employer’s discretion.

Authorization to check references
I hereby certify that the information contained in this application form is true and correct to the best of my knowledge and agree to have any of the information checked unless I have indicated to the contrary. I authorize the references listed above, as well as all other individuals whom the practice may contact, to provide any and all information concerning my previous employment and any other pertinent information that they may have. Further, I release all parties and persons from all liability for any damages that may result for furnishing the practice with such information as well as from the use or disclosure of such information by the employer or any of its agents, employees, or representatives. I understand that any misrepresentation, falsification, or omission of material information on this application may result in my failure to receive an offer, or, if I am hired, in my dismissal from employment.

Employment Relationship
If employed, I understand that employment with the practice is not for a specified term and can be terminated “at will”, with or without cause, and with or without notice, at any time. The “At Will” employment policy includes all employees including those presently employed by the practice. No employee or representative of the practice, other than the owner, has the authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing. Further, the employer may not alter the “At Will” nature of the employment relationship unless it is done specifically and in writing that is signed by the employer, I agree that this constitutes a final and fully binding agreement with respect to the “At Will” nature of my employment relationship. There are no oral or collateral agreements regarding this issue.