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Onaga - Physical Therapy Assistant Application

To enrich the health and the lives of the people we serve is more than a mission statement; it is our way of life.

You do not just have a job at CHCS, you have a purpose. When you become a member of the CHCS team you will consistently demonstrate our values and work within our operating pillars.

  • Be prepared to grow with CHCS; we will help you achieve your professional goals.
  • Listen to and respond with personal attention to the needs of patients, visitors, residents and co-workers.
  • Comply with Confidentiality Policy.
  • Recommend performance improvement ideas.
  • Seek additional assignments.
  • Take ownership of issues and situations. Be part of making things better.
  • Encourage co-workers by setting a positive example.
  • Think Safety and Work Safely.
  • Be proud of CHCS and take opportunities to tell others about CHCS.
  • Smile and greet patients, visitors and co-workers by name.
  • Maintain the CHCS Look – well groomed, clean, natural, polished and professional.
  • Treat co-workers with courtesy and respect.
  • Report to work as scheduled and on time; have reliable transportation.
  • Use work time efficiently.
  • Use our resources wisely.
I want to be part of the CHCS team and commit to:

Continue to the next page and complete the Employment Application.

Personal Information

* - Indicates a required field

Are you 18 years of age or older?*
Are you currently, or have you ever been, employed by this hospital?*

Work Desired

* - Indicates a required field

The following information is for the purpose of considering your employment request, and it does not constitute a promise or guarantee of employment. If employed, you are an "at will" employee.

Desired Employment Status*
Shifts Available For Work*
Are you eligible for work in the United States?*

If you are not a U.S. citizen, please list the type of Visa you possess and its expiration date

Are you currently excluded, or are you aware of any potential exclusions, from participation in any federally funded health care programs including Medicare and Medicaid?*
Have you ever applied at this hospital?*
Are you related to any team members or board members at this hospital?*

Education and Training

* - Indicates a required field

High School or Equivalent

College

Technical or Vocational School

Post-graduate or Other Training

Please indicate skills

Professional Licenses

* - Indicates a required field

References

* - Indicates a required field

Reference 1

Reference 2

Reference 3

Employment Record

* - Indicates a required field

Employer 1

Employment Dates

Employer 2

Employment Dates

Employer 3

Employment Dates

Employer 4

Employment Dates

Additional disclosures and agreements

Do not sign as requested below until you have read this entire form, understood its terms and conditions, and agree to the terms and conditions set forth herein. Your signature below indicates your agreement to the terms and conditions set forth in this application. The consideration for your acceptance of the terms and conditions set forth herein is the company's willingness to review your application and employment if you are selected for employment.

I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States, and that federal immigration laws require me to complete an I-9 Form in this regard. I further understand that to be eligible for employment, I must complete the entire application process which may include a medical examination.

I expressly authorize, without reservation, Community Healthcare System (CHCS), its representatives, associates or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the Company, its agents, employees or representatives, for seeking, gathering and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me.

In order to process your application, or during the course of your employment, a consumer report may be obtained on you for employment purposes. It may be an investigative consumer report that includes information regarding your character, general reputation, personal characteristics, and mode of living. Such report may also be necessary in relation to any investigation regarding allegations of sexual harassment, discrimination, or disciplinary charges associated with your employment. The employer may utilize an outside organization to obtain a consumer report and/or to conduct investigations. If an investigative consumer report is obtained, you have a right to request disclosure of the nature and scope of the report, which involves personal interviews with sources such as your neighbors, friends, or associates. I hereby authorize the employer to obtain a consumer report on me for employment purposes and to conduct investigations as outlined above.

I understand that the Company does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state or federal law.

I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the Company and still wish to be considered for employment, it will be necessary for me to reapply and complete a new application.

In consideration of my employment, I agree to conform to the company's rules, regulations, and policies and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the Company. I understand that no CHCS representative, other than its CEO, and then only when in writing and signed by the CEO, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing.

I further agree that, if employed, I will conform my conduct to Company's rules, regulations, policies and that I may not enter into any other employment or engage in any business which will conflict with my responsibilities as an employee of Company.

By signing below, I certify that all answers to questions in the application, and other reference documents referenced above are true and complete to the best of my knowledge. I understand that misrepresentation, omission, or falsified statements on this application or any other reference documents in any detail shall constitute sufficient cause for disqualification from further consideration for hire or for dismissal whenever discovered.

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