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Application Information

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Personal Data

Education

Professional References

Personal References

Previous Employment

Declaration

I declare that all statements contained in this application are true and correct, to the best of my knowledge, and authorize Peachtree Health Group to make any inquiry to determine my suitability for employment, with the understanding that any misrepresentations or omission made herein will be just and due cause for my discharge from employment regardless of when such misrepresentation may be discovered. I agree to submit to a criminal background check, reference check, employment physical and/or test for the presence of alcohol or controlled substances as required by PeachTree Health Group and by applicable regulations. Furthermore I understand and confirm that neither this application nor my being accepted for employment at Peachtree Health Group will be interpreted by me to create a contract of employment for any particular length of time. I understand that I may terminate my employment at will at any time for any reason and that Peachtree Health Group reserves the same right.

Applicant Consent Form

Satisfactory completion of a physical examination, including an alcohol and drug test, is a condition of employment. Applicants to whom a conditional offer of employment has been made will be required to submit to a physical examination and, for the purpose of alcohol and drug testing, will be required to disclose all medications prescribed and provide a urine sample, the collection of which may be observed by a person of the same gender. Refusal to submit to a physical examination, including an alcohol and drug test, failure to appear for the physical examination and urinalysis, and failure to cooperate in the physical examination or urinalysis will preclude employment with Peachtree Health Group. If there is evidence of current use of illegal drugs or abuse of alcohol, prescription drugs or a controlled substance by an applicant to whom a conditional offer of employment has been made, such person will not be employed at Peachtree Health Group. The undersigned consents to submitting to a physical examination, including urinalysis for the purpose of alcohol and drug testing.

Employee Certification

Disclaimer and Signature

PLEASE READ BEFORE SUBMITTING I CERTIFY THAT THE INFORMATION ON THIS APPLICATION IS CORRECT AND MAY BE INVESTIGATED INCLUDING, IN SOME CIRCUMSTANCES, A CRIMINAL BACKGROUND CHECK. I understand that if, in the judgment of PeachTree Health Group, any information has been misrepresented, falsified, or omitted, any offer of employment may be withdrawn or any employment terminated without any obligation or liability on the part of the company. I authorize PeachTree Health Group to act as my AGENT in obtaining information from any person or company concerning myself, without ability to such person or company, or to PeachTree Health Group. I understand that PeachTree Health Group operates 24 hours per day, 7 days per week and that weekend work or changes in schedule may be required during the term of employment as management see fit for the best interest of the residents as well as PeachTree Health Group. PeachTree Health Group is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship , age or disability. The opportunity for employment with this company depends solely on individuals' qualifications and ability to meet the requirements of their position.