I hereby authorize MEDALLION HOME CARE OF DE LLC to conduct background screenings as part of my employment consideration. I understand these screenings may include:

• Delaware Nurse Aide Registry (CNA Registry) check
• Delaware Adult Abuse Registry (DAAR) check
• Federal exclusion checks through the U.S. Department of Health and Human Services Office of Inspector General and System for Award Management
• State and national sex offender registry searches, including databases maintained by the U.S. Department of Justice
• Verification of prior employment, including service letter requests under Delaware law

I certify that the information I have provided is true and complete. I understand that any false statements or disqualifying findings may result in denial of employment or termination.

This authorization is valid for initial employment screening and ongoing compliance checks as required.