I hereby affirm that the information provided on this application is true and complete. I understand that any false or misleading representations or omissions made on the application or during the hiring process may disqualify me from further consideration for employment and may result in discharge even if discovered at a later date. I understand that employment may be conditioned upon successfully passing a medical examination and that I may be required to satisfactorily complete a drug screening as a condition of employment. I hereby authorize persons, schools, my current employer (if applicable), previous employers, and other organizations to provide this facility and its affiliates with any requested information regarding my application or suitability for employment, and I completely release all such persons or entities from any and all liability related to the providing or use of such information. I understand that my employment is at-will which means that I may terminate the employment relationship at any time and for any reason with or without notice, and that this company has the same right. I understand that no one has the authority to enter into any agreement contrary to the proceeding sentence, except for a written agreement signed by an administrative representative of this company and notarized. By signing below, I agree to all of the above and acknowledge that Solaris Healthcare, Inc. may conduct a detailed and thorough investigation which may include but is not limited to a criminal record check, motor vehicle record check, interviews or inquiries of prior employers, coworkers, acquaintances, relatives or friends. I authorize the company to supply my employment record, in whole or in part, and in confidence, to any prospective employer, government agency, or other party, with a legal and/or proper interest.