I certify that the information given by me in this application and during the interview process is true and complete to the best
of my knowledge and understand that, if employed, falsified or misleading statements may result in my being disqualified from
consideration for employment (or subject to immediate dismissal if discovered after I am hired).
I further understand that this application is not intended to be a contract of employment, nor does this application obligate the
employer in any way if the employer decides to employ me. I understand and agree that if hired my employment is at-will and
can be terminated by me or the company at any time with or without cause. I also understand and agree that no one other than
the Vice President of Clinical Operations and another Senior Manager together has any authority to enter into any agreement
for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and
signed by the Vice President of Clinical Operations and another Senior Manager.
I understand that any offer of employment I may receive will be conditioned on my taking and passing a medical examination
given by Longleaf Hospice or its designees, and that the exam may include, but is not limited to, any or all of the following
(unless otherwise restricted by law): physical exam, mental exam, and drug screening tests. I understand that if I fail to take
such tests or the results are unsatisfactory, I will not be hired by Longleaf Hospice.
This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the
Americans with Disabilities Act (ADA) and other relevant federal and state laws.
I understand that applications are kept in active status for thirty (30) days so that they may be considered for vacancies during
that period. If I wish to be considered for employment after that time, I must reapply.