Phone: 205 939 4122
 
Email: info@expectcare.com

Application

Complete form and submit
Qualified applicants are considered for all positions without regard to race, color, religion,sexual preference, national origin, age, martial status, or physical or mental handicap.
NOTE: Answering yes to this question does not constitute an automatic bar from employment with ExpectCare, LLC and All Affiliates.
PAST EMPLOYMENT :
How did you hear about us? :
What days/hours are you available to work? :

CLERICAL/OFFICE/COMPUTER SKILLS :

SKILLS/EXPERIENCE :
COMPUTER SKILLS :

MEDICAL SKILLS :

OFFICE :
LAB SKILLS :
EXPERIENCE FIELDS OF WORK :
PATIENT CARE :
BILLING :
GENERAL MEDICAL SKILLS :
X-RAY SKILLS :
FOR OFFICE USE ONLY :
CONSENT FOR BACKGROUND INVESTIGATION :
I hereby authorize ExpectCare and/or its affiliates to make an independent investigation of my background, references, character, credit history, past employment, education, criminal and organizations and all public records for the purpose of confirming the information contained on my application, resume, or in the supporting documentation and or obtaining information which may be material to my qualifications for employment. I release ExpectCare and/or its affiliates, any person or entity which provides information pursuant to this authorization form, any and all of the above referenced sources used. I further understand that ExpectCare and/or its affiliates will adhere to applicable state and federal statutes concerning the securing of the information, handling, and release of information obtained in the pre-employment investigation. The following is my true and complete legal name and all information on this document is true and correct to the best of my knowledge.
RELEASE AND CONSENT TO DRUG AND ALCOHOL TEST :
In consideration for the possibility of employment or continued employment with ExpectCare and/or its affiliates, I consent to submit to a drug/alcohol test by urinalysis or other method. I authorize any laboratory or medical care provider to release such examination and test results to ExpectCare and/or its affiliates. I also authorize ExpectCare and/or its affiliates to release results of such tests to any government agency, which has any interest in my employment with ExpectCare and/or its affiliates, in return for the companies considering my employment application or considering my continued employment. I release ExpectCare and/or its affiliates and its officers, agents, and employees from all claims and damages related to this testing program, and I covenant not to sue such parties for requiring the test or for taking any adverse employment actions based on the test.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. WE DO NOT DISCRIMINATE IN HIRING OR DURING EMPLOYMENT ON THE BASIS OF RACE, COLOR, RELIGION, NATIONAL ORIGIN, SEX, CITIZENSHIP, DISABILITY, AGE, OR VETERAN STATUS. NO QUESTION ON THIS APPLICATION IS INTENDED TO SECURE INFORMATION FOR ANY DISCRIMINATORY PURPOSE.
I certify that all of the information that I have provided on this application is true and accurate.
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