CHIROPRACTOR PHYSICIAN CREDENTIALING

In order to provide me with work opportunities and to comply with Florida DOH/AHCA regulations, I hereby authorize All Care Consultants, Inc. to make an independent investigation of my background and criminal or police records. I release All Care Consultants, Inc., and any person or entity which provides information pursuant to this authorization, from any and all liabilities, claims, or lawsuit in regards to the information obtained from any and all of the above sources. The information contained in this Application is complete and correct to the best of my knowledge. I understand that any omission of material fact on this Application may be grounds for rejection of this Application or may result in my release from employment. I also understand that any offer of employment and continued employment is contingent upon the results of this background check.