I hereby certify that all of the information provided by me in this application (or any other accompanying documents) is correct,
accurate and complete to the best of my knowledge. I understand that the falsification,
misrepresentation or omission of any facts in said documents will be cause for denial of employment or immediate termination of
employment regardless of the timing or circumstances of discovery.
I understand that submission of an application does not guarantee employment. I further understand that if an offer or employment is extended by Preferred Imaging and/or an Affiliate (herein after referred to as
Preferred Imaging) that such employment with Preferred Imaging is at will, for no specified duration and may be terminated by either Preferred Imaging or myself at any time, with or without cause or notice.
I understand that none of the documents, policies, procedures, actions, statements of Preferred Imaging's representatives used during the employment process is deemed a contract of employment real or implied.
I understand that no representative of Preferred Imaging except the President has the authority to enter into
any agreement guaranteeing any conditions of employment or any agreement contrary to the foregoing statements and the agreements must be made in writing and signed by the President of Preferred Imaging.
I understand that if offered a position at Preferred Imaging, I may be required to submit to a pre-employment medical examination, drug screening and background check as a condition of employment. I understand that unsatisfactory results from,
refusal to cooperate with or any attempt to affect the results of these pre-employment tests will result in withdrawal of any employment offer or termin- ation of employment if already employed.
I herby authorize any and all schools, former employers, references, courts, and any others who have information about me to provide such information to Preferred Imaging and/or any of its representatives,
agents or vendors and I release all parties involved from any and all liability for any and all damage that may result from providing such information.
I understand that this application is considered current for ninety (90) days. If I wish to be considered for employment after this period I must fill out and submit a new application.
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* For information on Select Pain Centers, visit www.selectpain.com.
* For information on Sandra O'Neal Institute, visit www.sandraoneal.com.