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I certify that all the information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. I understand that Vail Health may request an investigative consumer report from a consumer reporting agency. I understand I have the right to make a written request within a reasonable time for the disclosure of the name and address of the consumer reporting agency so that I may obtain a complete disclosure of the nature and scope of the investigation. Vail Health may request information as to my character, reputation, personal characteristics and mode of living from my neighbors, friends, former employers, school and other. I authorize that investigation of any or all statements contained in this application and also authorizes whether listed or not, any person, school, current employers (except as previously noted), past employers and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying. I agree to immediately disclose to Vail Health any debarment, suspension, exclusion, conviction of a criminal offence, or other event that may make me ineligible to participate in federally funded healthcare programs. I understand and I will be required to successfully pass a drug screening examination. I hereby consent to a drug screening as a condition of employment.

I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. IF EMPLOYED , I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF VAIL HEALTH OR ONE OF ITS OUTREACH FACILITIES AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OUT WITHOUT CAUSE AND WITH OR WITHOUT NOTICE.