As part of our commitment to quality and excellence, Sentara Healthcare will continue to maintain a safe, healthy environment for you by requiring all applicants to submit to a criminal history check and those tentatively selected for a position to submit to screening for illegal drug use prior to appointment for a job. In addition, applicants may be screened for ability to perform essential functions of some positions. In light of this, we request that you read and accept the following Consent Agreement and Disclosure Statement.
As an applicant, I hereby affirm that I have not ever been convicted of a felony, nor am I subject to pending criminal charges for any of the following offenses within or outside the Commonwealth of Virginia except as already noted on application. Criminal offenses include murder, abduction for immoral purposes, assault, battery, robbery, pandering, arson, crimes against nature involving children, taking indecent liberties with children, abuse and neglect of children, failure to secure medical attention for an injured child, sexual assault, obscenity offenses, crimes against the person, crimes against property, crimes involving fraud, crimes involving health and safety, crimes involving morals and decency, abuse or neglect of an incapacitated adult, crimes related to healthcare, listed by any Federal agency as debarred, excluded or ineligible for participation in federally funded health programs.
I also understand that if I have been convicted of a barrier crime, I cannot work for Sentara Life Care, Sentara Home Care or Medical Transport, LLC. If I have been convicted of a health-care related crime or debarred, excluded or ineligible for participation in Federally funded health programs, I understand that I am ineligible for employment with Sentara.
I understand that final confirmation of any job offer will be contingent upon my undergoing a pre-employment drug screening, and that failure to submit to such screening, the falsification of a screen, or a positive finding on a test will remove me from consideration for employment for one year. I consent to the screening and will report for screening on the day assigned by Sentara.
I also understand that some positions require an ability to meet physical demands that serve as the essential functions of the job. For these positions, I understand that I may be required to demonstrate that I can perform the essential functions of the job.
I understand that, if hired, I am required to attend a Sentara Healthcare orientation which is generally held on Mondays at a Sentara Facility. I must also attend divisional/departmental orientation as scheduled.
Nothing herein creates either a contract or offer of employment. Although the information provided on this site is believed to be correct, it is not guaranteed.
I certify that statements herein are true. I understand that false or incomplete statements herein or the omission of any information requested, or inaccurate information I have submitted are grounds for dismissal. I agree that a thorough examination of my employment except as it pertains to race, color, religion, national origin, sex, age, disability or genetic information may be made and used relative to my employment. I authorize my former employers and any other persons or organizations to provide any factual information they have about my employment and I release all concerned from any liability in connection therewith. If employment is offered, I understand that I may be required to work varied shifts, weekends and overtime, and successfully complete the employee health examination as required by Sentara Healthcare. I understand that employment with Sentara Healthcare or any of its subsidiaries is terminable at either the will of the employee or employer at any time. Sentara Healthcare is an equal opportunity employer. Prior to the completion of the hiring process, I acknowledge that I may be required to sign a non-electronic form that confirms that all of the information I have provided Sentara is correct.
Last updated: 7/15/2013
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