Authorization & Disclosure

We truly welcome your application for employment with the APREMIUM HEALTHCARE.  We are proud of our success and recognize it as the result of the quality and caliber of the employees in our organization. In pursuit of that excellence, we require as a condition of employment and/or continued employment that all applicants consent to and authorize a pre-employment verification of the background information submitted on their application and résumés.

This release and authorization acknowledges that this company and MBI, a consumer reporting agency, may now, or at any time while you are employed, administer testing instruments, conduct and retrieve a verification of your education, previous employment/work history, credit record, contact personal references, require that you provide a urine/breath/blood specimen to be tested for the presence of drugs or alcohol, access motor vehicle records, worker’s compensation records and to receive any criminal history record pertaining to you which may be in the files of any federal, state, county or local criminal justice agency in any State and/or other information deemed necessary to fulfill the job requirements. The information received may include, but may not be limited to, the aforementioned agencies. The results of this verification process will be used to determine employment eligibility. Convictions for a felony or misdemeanor will not necessarily be a bar to employment.

I authorize MBI Worldwide South of Herrin, Illinois (referred to as "MBI") and any of its agents/designated representatives to disclose orally, electronically, and in writing the results of this verification process and/or interview to the designated authorized representatives of this Company.

I do hereby forever release and discharge the Company, its agents, MBI, and its associates to the full extent permitted by the law from damages, losses, liabilities, costs and expenses, or any other charge of complaint filed with any agency arising from the retrieving and reporting of information. According to the Federal Fair Credit Reporting Act, I am entitled to know if adverse action is taken based on information obtained by the Company and to receive orally, written or electronically a copy of the consumer report and a description of the rights of a consumer. I agree that any copy of this document is as valid as the original.

I hereby certify that all of the statements and answers set forth on the application form and/or my résumé are true and complete to the best of my knowledge. I understand that if subsequent to employment any such statements and/or answers are found false or that information has been omitted, such false information or omissions will be considered as cause for possible dismissal.

You can proceed with your application by filling the Consent Form

If you have any problems completing this application, please email This email address is being protected from spambots. You need JavaScript enabled to view it.