Long Meadow Veterinary Clinic Employment Application

Skills and Knowledge Self Reflection
Please assess yourself in each of the following catagories in the manner most consistent with your current skills/knowledge in each area. All experience levels will be considered, but this will assist us in your placement, training, and scheduling if selected for a position.
Basic Skills
Communication Skills in Written and Spoken English
Interpersonal Skills
Analytical Problem Solving Skills
Ability to Prioritize Multiple Tasks
Time Management Skills
Basic Computer Skills
Microsoft Office Suite (Word, Excel, Power Point) Computer Skills
Google Based Programs (Gmail, Google Docs, Google Sheets, Etc) Computer Skills
Typing Speed (free wpm test at www.typingtest.com):
Other Communication Skills
Do you speak a language other than English?

YesNo
If yes, what other language do you speak?
Verbal Fluency in Specified Language
Written Fluency in Specified Language
Small Animal Medical/Health Skills and Knowledge:
Canine Restraint
Feline Restraint
Husbandry
Physiology
Behavior
Life Stages
Vaccine Protocols
Infectious Diseases
In-house Blood Work
Fecal Examinations
Skin/Ear Cytology
Anesthesia Induction/Monitoring
Dental Charting/Cleaning/Polishing
Dental Radiology
Surgical Assistance (Sterile Gowning/Gloving/Opening Packs)
Euthanasia

References:
Please provide at least 2 references who are not family members. You may provide additional.
Reference #1 Name
Reference #1 Relationship
Reference #1 Phone
Enter Phone Number Including Area Code
Reference #1 Email
example@example.com
Reference #2 Name
Reference #2 Relationship
Reference #2 Phone
Enter Phone Number Including Area Code
Reference #2 Email
example@example.com
Would You Like To Provide Additional References?

YesNo
Reference #3 Name (Optional)
Reference #3 Relationship
Reference #3 Phone
Enter Phone Number Including Area Code
Reference #3 Email
example@example.com
Would You Like To Provide Additional References?

YesNo
Reference #4 Name (Optional)
Reference #4 Relationship
Reference #4 Phone
Enter Phone Number Including Area Code
Reference #4 Email
example@example.com
Would You Like To Provide Additional References?

YesNo
Reference #5 Name
Reference #5 Relationship
Reference #5 Phone
Enter Phone Number Including Area Code
Reference #5 Email
example@example.com
Please list any friends or relatives currently or previously employed by Animal ER of Northwest Houston

Statements of Acknowledgement and Submission
You can print out a copy of this application after you submit it. Your application will be digitally submitted and kept in a secure location regardless of your employment status.

Please read the following statements completely and initial each statement. Your initials and signature on this application indicates your understanding and acceptance of these statements. If you have any questions or concerns about this application or these statements please address them with Logan Erck BEFORE signing this application.
I understand that, as a condition of employment, I will be required to provide legal proof of authorization to work in the U.S.A. Please INITIAL*

Clear
I understand that, as a condition of employment consideration, I will be required to consent to a complete background check and drug screening. I understand that, if hired, Animal ER of Northwest Houston, may terminate my employment due to any negative results found on any of these pre-employment policies. Some examples may be but are not limited to Felony, Misdemeanor, Substance Abuse, Harassment, Physical Abuse, Theft, Burglary, etc. Please INITIAL*

Clear
I understand that the State of Texas requires all males who are 18 through 25 to register with the Selective Services, and I will be required to present either proof of registration or exemption from registration upon hire. Please INITIAL*

Clear
I authorize any of the persons or organizations referenced in this application to give you any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application, and I release all such parties from all liability from any damages which may result from furnishing such information to you. Please INITIAL*

Clear
I understand that there is no express or implied contract of employment, and that if employed, I have been hired at the will of the employer and that my employment may be terminated at will, at any time, and with or without cause—the employer’s only obligation being to pay salary or wages due and owing at the time of termination. Please INITIAL*

Clear
I understand that all company property must be returned and my debt to the company must be paid before my termination. I authorize the company to deduct from the final paycheck(s) all monies due and owing to the company. Please INITIAL*

Clear
I understand that some of the conditions in this workplace are especially hazardous to women who are pregnant or people who are immunocompromised. This includes radiology, anesthesia, some medications used, and some potential infectious diseases encountered in daily interaction with animals. I understand that I am not required to report any change in my health status to my employer, but if I chose to report my condition to my supervisor it will be kept private. I will be informed of the risks in this workplace and placed in a position that minimizes the risks I am exposed to as much as possible. Please INITIAL*

Clear
Prospective Employee FULL Signature: I certify that all of the information provided by me in connection with my application, whether on this document or not, is true and complete, and I understand that any misstatement, falsification, or omission of information shall be grounds for refusal of hire or, if hired, termination.

Clear
Should be Empty:

Basic Information

Educational Background Information

Previous Employment or Volunteer Information

Skills and Knowledge Self Reflection

Basic Skills

Other Communication Skills

Small Animal Medical/Health Skills and Knowledge:

References:

Statements of Acknowledgement and Submission