Work Day, Inc.

Tobacco-Free Environment

Because we are concerned about your health and well being, Meadows Regional Medical Center is designated tobacco-free. Associates are prohibited from using tobacco products during their working shifts on this campus. Thank you for not smoking or using tobacco products while visiting our campus.

Applicant Statement

I certify that the information given by me in this application is true and complete in all respects, and I agree that if the information given is found to be false in any way, it shall be considered sufficient cause for denial of employment or discharge. I authorize the use of any information in this application to verify my statements, and I authorize the past fellow employees and employers, all references, and any other persons to answer all questions asked concerning my education, reputation, personal characteristics, ability, character, mode of living, and previous employment record. I understand that this information will be used solely for the purpose of determining my qualifications for employment and hereby release from liability my previous employer, educational institution, or references and Meadows Regional Medical Center for the giving, obtaining and use of this information in making employment decisions.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the employee may resign at any time and the employer may discharge the employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between Meadows Regional Medical Center and myself for either employment or for the providing of any benefit. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon Meadows Regional Medical Center unless made in writing.

I further understand that if an offer of employment is tentatively made to me, it is conditioned upon my successful completion of a medical evaluation and pre-employment technical proficiency test (if applicable) that includes verification of ability to meet physical standards and perform essential functions for the job for which I am applying. In the event I have a disability that will affect my ability to take the pre-employment test, I will so inform Meadows Regional Medical Center prior to the administration of the test so that a reasonable accommodation can be made. Requested accommodations may include accessible testing sites, modified testing conditions, and accessible testing formats. Meadows Regional Medical Center reserves the right to require medical documentation concerning the need for the accommodation.

I agree to furnish such additional information and complete such examinations (including periodic physical examinations and periodic tests for controlled substances or alcohol) as may be required by Meadows Regional Medical Center. Meadows Regional Medical Center operates as a drug free workplace. I agree and understand that my initial and continued employment is contingent upon my submitting to such examinations or tests when requested and that refusal to take such an examination will subject me to termination. I further understand, and agree, that under a drug free workplace policy personal property located on company premises, including my vehicle, are subject to search for contraband or controlled substances at any time.

Pursuant to the Immigration Reform and Control Act of 1988, all applicants, upon being made an offer of employment, must produce documents that are specified by the Federal Government, establishing their identity and authorization for employment in the United States. These documents must be produced no later than seventy-two (72) hours after commencement of employment. You will also be required to sign Form I-9 (issued by the Federal Government) verifying, under oath, your employment authorization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

I understand that, if employed, policies and rules which are issued are not conditions of employment and that the employer may revise policies or procedures, in whole or in part, at any time.

I understand that this application will be kept on active file for 60 days from the date completed, after which time I would have to reapply I accordance with established company procedures.

Meadows Regional Medical Center believes that all persons are entitled to equal employment opportunity and does not discriminate against its employees or applicants for employment because of age, disability, equal compensation, genetic information, national origin, pregnancy, race, color, religion, retaliation, sex or sexual harassment.

Employee Health Policy Requirements

Please note that employment with Meadows Regional Medical Center and/or its affiliates will require compliance with all Employee Health Policy requirements including, but not limited to:

1. Tdap (combined tetanus, diphtheria and pertussis) vaccination and/or proof of prior vaccination.
2. MMR (measles, mumps & rubella) proof of vaccination; and
3. Varicella (chicken pox) proof of vaccination.

Post Employment:
4. 2-step TST (tuberculosis) testing (with annual submission); and
5. Flu vaccination (with annual submission).

If selected for possible employment, I will submit to an initial TST (Tuberculosis) Test and ongoing annual TST Testing. I agree to follow MRMC's policy if I test positive for possible Tuberculosis.

I have read and understand this authorization and release.

Disagree Agree