Entrusted Heart Homecare Application Logo
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  • Employment Desired:

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  • Current Employment:

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  • Previous Employment:

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  • Disclaimer & Signature:

  • By signing and clicking the submit button below, I certify that the facts contained in this application are complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview
    shall be grounds for dismissal.

    I authorize investigation of all statements contained in this application, and hereby authorize any person, educational institution, or company I have listed as a reference on my employment application to disclose in good faith any information they may have regarding my qualifications and fitness for employment. I will hold Entrusted Heart Homecare LLC, any former employers, educational institutions, and any other persons giving references free of liability for the exchange of this information and any other reasonable and necessary information incident to the employment process.


    I additionally authorize and agree upon a criminal background check and hereby release Entrusted Heart Homecare LLC from all liability for any damage that may result from utilization of such information.


    I agree and contract that any and all claims, disputes, controversies, whether based on contract, quasi-contract, tort, offenses, quasi-offenses or otherwise, arising out of, or in any way related to this application for employment, whether based on the constitution, statutes, code(s), and/or common law of the United States or of any state, including the arbitrability of any claim, dispute or controversy shall be exclusively settled by binding arbitration conducted under the arbitration ruled of and before an arbitration tribunal of the National Association for Dispute Resolution, Inc. All claims of any rights to the contrary, including any right to trial by jury, being hereby expressly waived.

    I understand and agree that my employment is for no definite period and may, regardless of the date of payment of my wages and/or salary, be terminated at any time without prior notice. I also understand that should the leasing agreement between Entrusted Heart Homecare LLC and the Client to whom I am assigned be terminated, my employment with Entrusted Heart Homecare LLC is terminated.  

     

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