• My Information

  • Format: (000) 000-0000.

  • Application Questions

  • Are you an internal candidate?*
  • Employment Type*
  • Shift Preference*
  • Available to Start*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Are you legally authorized to work in the United States?*
  • Have you ever been discharged or asked to resign from a job?*
  • Are you related to a current Physicians Premier employee?*
  • Have you ever been convicted of any violations of law?*
  • Date of Offense
     - -
    2 digit month, 2 digit day, 4 digit year
  • Date of Conviction
     - -
    2 digit month, 2 digit day, 4 digit year

  • Resume

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  • May we contact your current employer*

  • Licenses/Certifications

  • Expiration Date
     - -
    2 digit month, 2 digit day, 4 digit year

  • References

  • Reference #1

  • Format: (000) 000-0000.

  • Reference #2

  • Format: (000) 000-0000.

  • Reference #3

  • Format: (000) 000-0000.

  • Job Application Certification

  • I hereby certify that all entries on this job application and any attachments are true and complete.  I also agree and understand that any falsification of this information may result in my forfeiture of employment.

    Physicians PremiER Management Services, LLC, Coastal ER I, LLC, Coastal ER II, LLC, Coastal ER III, LLC, Coastal ER IV, LLC, Coastal ER V, LLC, Coastal ER IX, LLC, Coastal ER XI, LLC, Coastal ER XII, LLC, Coastal ER XIII, LLC, and Brazos Valley ER, LLC dba Physicians PremiER are equal opportunity employers. We do not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service.

    I understand and agree that my employment is at‐will and can be terminated with or without cause and with or without notice at any time at the option of either me or the Company. I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Company to hire me.

    I understand that all information on this job application is subject to verification and I consent to criminal history and background checks.  I also agree that you may contact references and educational institutions listed on this application.

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