Please list your 2 most current work history/experience

I hereby state that all information provided is accurate and may be verified by you. I agree that I may be discharged if Well Doctor at anytime learns of falsification or material omission in the information provided on this application form and related documents. Well Doctor may contact my former employers. All references are hereby authorized to release all information which they may have relevant to my employment with them. I hereby release Well Doctor , its affiliates, successors, and assigns, and all references from any liability that might be claimed because of information provided by such references. I agree that I will follow all Well Doctor policies, rules, and procedures. I understand that Well Doctor reserves the right to add, change, and/or delete any policies, procedures, work rules, and/or benefits at anytime. I agree to make myself available for random drug testing. I have never been convicted of a felony and I have no criminal charges pending against me.