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Marvel Medical Consent Form

Full SSNs required.

Are you willing to submit to a drug screen?

Are you willing to submit to a criminal background check?

Do you have any limitations that would restrict you from performing essential functions in the position for which you are applying for?

Have you ever received disciplinary action on any professional license held within the United States?

I certify that all statements made in this application are true to the best of my knowledge. I understand that all falsification or misleading information given in my application may result in the termination of my employment with Marvel Medical Staffing. Furthermore, I understand that my professional conduct and clinical performance is directly related to my ability to be placed on assignments for Marvel Medical Staffing and that I will adhere to all expectations set forth in the employee handbook. I authorize Marvel Medical Staffing to verify the information I have provided, to contact references, and to conduct a criminal background check concerning my qualifications and past employment record. I understand that nothing contained in this application is intended to create an employment contract, either verbal or written with Marvel Medical Staffing or its clients. Furthermore, I understand that in the event of my employment, it is “at will” and Marvel Medical Staffing or I may terminate my employment at any time with or without notice and with or without case.