To the best of my knowledge, I certify that the answers given are true and complete and that purposeful misrepresentation may result in the rejection of my application.  I authorize the investigation of all statements contained in this application, as required.  Additionally, I authorize former employers, references, and other individuals/organizations to provide information to Heart & Hands Care Service LLC. I hereby release and discharge any of the above and Heart & Hands Care Service LLC from any liability of any kind or nature.   I also understand that it is my responsibility to keep such information current and accurate by updating it as often as necessary.

If requested, I agree to a physical examination and understand that failure to meet any medical and/or health requirements for the position may prevent my employment with the Agency.  For certain positions, I also understand that employment may be conditional upon successfully completing a substance abuse screening test if part of the Agency’s pre-employment policy.

I certify that I am able to stand for a 4 hour period of time and perform the duties required of the job. Furthermore, I certify that I am free of any infectious diseases that might affect the clients I work with.

I understand that, if hired, I may be required to provide proof that I am a citizen of the United States or proof that I am currently authorized to work in the United States.