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Employment Application Form

This field is for validation purposes and should be left unchanged.

Your Personal Information

IMPORTANT: Applicants with disabilities may request any reasonable accommodation necessary to complete this application, or to take any test required for the position for which the applicant has applied, by making a request at the time of application or testing.
Your Name(Required)
Address
Email
Phone number
When is the best time for us to reach you via telephone?

Position You're Applying For

EQUAL EMPLOYMENT OPPORTUNITY: It is the ABHS’s policy to seek and employ the best qualified employees and to provide equal opportunity for the advancement of employees and to administer all of our employment policies in a manner that will not discriminate against any person because of race, color, religion, age, sex, sexual orientation, gender identity, marital or veteran status, national origin, ancestry, disability, genetic information, on-the-job injuries, or any other legally protected status.
MM slash DD slash YYYY
MM slash DD slash YYYY

Work Availability

Please mark only the days you are available to work under each shift listed. (ABHS will attempt to reasonably accommodate employees who require certain hours or days off or other reasonable accommodations because of religious beliefs or practices.)
Shifts
Days

Have you ever worked for us before?
Are you 18 years of age or older?
How did you hear about us?
Please type referral name or details for other option
RELATIVES AND FRIENDS
Qualified relatives and friends are eligible for employment except in unusual situations when the Company needs to avoid possible conflicts of interest. Do you have any relatives or friends (such as roommates or domestic partners) who currently work for us?

IMPORTANT NOTICE TO ALL APPLICANTS
CRIMINAL AND/OR DRIVING RECORDS: ABHS may ask for additional information from applicants who receive a conditional offer of employment. The additional information will be about the applicant’s criminal and/or driving record, including convictions of any crime (whether a felony, misdemeanor, or other violation or offense), or pleas of guilty or no contest, or forfeitures of bail or bond. We may also ask for this information as part of a background check. A criminal or driving record is not an automatic bar to employment. Factors such as the nature and gravity of the crime, the length of time since the conviction and/or completion of any sentence, and the nature of the job for which you have applied will be considered.

DRUG TESTING: All offers of employment are subject to a urinalysis or alternative test(s) for the presence of unlawful drugs.

IN CASE OF EMERGENCY NOTIFY

Qualifications

Please list any education, training and/or specialized experience (such as schools; colleges; degrees; vocational, technical or military experience, hobbies, etc.) you believe would help you perform the work for which you are applying.
(Name/address of school, program, military branch and specialty, or other source)

Employment Experience

Please account for all periods of employment by month and year, including any self-employment and military service. (Attach another sheet if you need more space.)
Current or Most Recent Employer
MM slash DD slash YYYY
MM slash DD slash YYYY

Previous Employer
MM slash DD slash YYYY
MM slash DD slash YYYY

Previous Employer
MM slash DD slash YYYY
MM slash DD slash YYYY

Have you ever been terminated, quit at an employer’s request, or quit because you believed that you might be terminated?

VERIFICATION, AUTHORIZATION AND SIGNATURE(Required)
1. I authorize the investigation of all matters which ABHS deems relevant to my qualifications for employment, including all information given in this application and in any supplemental application attachments or supporting documents. I authorize you to request and receive such information, and I release from all liability any persons (such as current or former supervisors or employers) supplying it. I further agree to sign an Authorization and Consent form allowing an outside agency selected by ABHS to verify all of the information I have provided as well as to provide any other information ABHS deems relevant to my qualifications or suitability for employment. I also release you from all liability which might result from making the investigation.

2. I certify that the facts and information in this application and in any attachments or supporting documents are true and complete to the best of my knowledge. I understand that any falsification, misrepresentation or omission, as well as any misleading statements or omissions, generally will result in denial of employment or immediate termination, regardless of when and how discovered.

3. I understand that I may be required to submit to pre- or post-employment physical or other professional examinations, medical inquiries and/or urinalysis or alternative tests for the presence of drugs and/or alcohol. I agree to such examinations, inquiries and/or testing at the ABHS's expense. I authorize release of the results to ABHS and their use to evaluate my suitability for employment. I also release ABHS from all liability arising out of or connected with any examinations, inquiries and/or testing.

4. I understand and agree that I may resign or be terminated, without cause or notice, at any time, unless otherwise stated in a written employment contract. I also understand and agree that ABHS’s President is the only person who will ever have the authority to agree to any other terms and/or to enter into such contracts, and that all such agreements for other terms of employment or contracts must be in writing and signed by both parties. I also understand that unless otherwise stated in a written employment contract, ABHS may change, withdraw and interpret other policies (including wages, hours and working conditions) as it deems appropriate.

5. This application for employment will only be considered active for 60 days.

6. I understand and agree that if I am hired, the statements in these paragraphs will become a binding part of my employment relationship. I have read (or had read to me in a language I understand) each of these statements. I have also reviewed all of the information provided in this application and in any attachments or supporting documents.
Unsigned or incomplete applications will not be considered.(Required)
Clear Signature
MM slash DD slash YYYY
Unsigned or incomplete applications will not be considered.(Required)
Clear Signature
MM slash DD slash YYYY

Reference Checking Consent & Authorization Form(Required)
Read carefully and completely before signing.

SECTION I – CONSENT
I have applied for employment with American Behavioral Health Systems and have provided information about my previous employment. My signature below authorizes my former or current employers and references to release the contents of my employment record with their organizations and to provide any additional information that may be necessary for my application for employment to American Behavioral Health Systems, whether the information is positive or negative.

I authorize American Behavioral Health Systems to investigate all statements made in my application for employment and to obtain any and all information concerning my former/current employment. This includes my job performance appraisals/evaluations, wage history, disciplinary action(s) if any, and all other matters pertaining to my employment history. I knowingly and voluntarily release all former and current employers, references, and American Behavioral Health Systems from any and all liability arising from their giving or receiving information about my employment history, my academic credentials or qualifications, and my suitability for employment with American Behavioral Health Systems. This form may be photocopied or reproduced as a facsimile, and these copies will be as effective as a release or consent as the original which I
sign.
SECTION II – SIGNATURE(Required)
Clear Signature
MM slash DD slash YYYY

References

Please list three (3) professional references.

Professional Reference #1

Company address

Professional Reference #2

Company address

Professional Reference #3

Company address

Upload your cover letter in .pdf, .doc or .docx format
Accepted file types: pdf, doc, docx, Max. file size: 25 MB.
Upload your resume in .pdf, .doc or .docx format
Accepted file types: pdf, doc, docx, Max. file size: 25 MB.

American Behavioral Health Systems, Inc exists for the purpose of serving those in need of behavioral health intervention in order to regain effective control of their lives. We believe that most individuals have the ability to overcome their personal difficulties, but often, are in need of assistance, guidance, and counseling in order to successfully reach their goal. Through continued assessment, education, and intervention, American Behavioral staff will diligently address the needs of all clients admitted into our programs.

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  • Admissions
    • Application Process
    • What To Expect
    • Payment Options
    • Family & Friends
  • Services Offered
    • Crisis Stabilization
    • Secure Withdrawal Management Services
    • Residential Treatment
    • Referrals
  • About Us
    • Contact Us
    • Careers
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