CONSENT AND CERTIFICATION
Notice: An invesigative consumer report involving information concerning your character, employment history,
general reputation, police record, personal habits, mode of living, credit history, and indebtedness may be
obtained prior to any offer of employment. Upon timely written request to the Corporate Office, the name and
address of the reporting agency will be disclosed to you.
I certify that the answers given by me in this application are true, correct, and complete. I agree that any
misstatement or pertinent omission made by me in this application may result in my rejection, or if hired, may
subsequently subject me to dismissal. Moreover, I understand that offers of employment may be conditioned upon
passing a physical examination and/or drug test. I authorize any company, school, police, or security personnel,
or other person to give any information regarding my employment, habits, ability, or any other characteristics
whatsoever, together with any information they may have regarding me whether or not it is in their records. I hereby
release all persons from liability and agree to hold harmless any person(s) for such testing, or issuing this information.
It is agreed and understood that completion of this application does not mean a job opening exists and in no way
obligates Gilbert Hospital to employ me.
In the event of employment, I will comply with all company rules, regulations and directives as may be established from
time to time. I am willing to work all assigned overtime or other special work assignments as requested by Gilbert
Hospital. Furthermore, since the company does not offer contracts of employment (unless signed by the company
President), I understand that nothing contained in this application form or any other company document, employee
handbook, or statement creates a contract between Gilbert Hospital and me for either employement or the provision of
any compensation or benefits. I understand that, if employed, I have the right to terminate my employment at any
time, for any reason, or no reason, and likewise, Gilbert Hospital has the same rights.