Our clients depend on us to hire dependable, compassionate, and sincere caregivers. Please assist us by completing the needed information below.
I authorize the release of employment information to Sincere Home Care, LLC., concerning my qualifications and past employment history. I hereby release you from any and all liability in supplying information or answering questions concerning my employment.
Background study result must be complete, cleared and in accordance with Minnesota Statue 245C.14 before an employee candidate receives
a hire date and allowed to begin working for Sincere Home Care. Sincere Home Care Human Resource department will notify the potential
staff, client (if applicable) and/or the responsible party of an employee’s employment eligibility upon receipt of the background study results.
- ONLY COMPLETE BACKGROUND STUDY AUTHROIZATION FORMS CAN BE SUBMITTED.
- TWO FORMS OF IDENTIFICATION, INCLUDING A VALID PICTURE ID WILL BE NEEDED FOR THE SUBMISSION OF THIS BACKGROUND STUDY.
Please fax a colored copy of your ID to Fax # 763-208-6089, or Scan & Email to email@example.com
THE FOLLOWING MUST BE COMPLETED BY THE EMPLOYEE. * = Required Fields
I hereby authorize Sincere Home Care (SHC) to thoroughly investigate my background, references, employment record and other matters related to my suitability for employment. I authorize persons, schools, my current employer, (if applicable) previous employers and organizations contacted by SHC to provide any relevant information regarding my current and/or previous employment. I understand that misrepresentation or omission of facts may result in rejection of this application, or if hired, discipline up to and including dismissal. I understand that nothing contained in this application, conveyed during any interview which may be granted, is intended to create an employment contract. I understand that filling out this form does not indicate there is a position open and does not obligate SHC to hire me. I understand and agree that my employment is at will, which means that it is for no specified period and may be terminated by me ore SHC at any time without prior notice. If for any reason, I terminate my employment willingly, I understand that I am required to submit a two-week notice prior to termination.