***PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY***
It is the company's policy not to refuse to hire a qualified individual with a disability because of this person's need for a reasonable accommodation that would be required by the ADA.
I understand and agree that any job offer is conditional and may be contingent upon satisfactory results of a post-offer medical examination (which may include drug and alcohol screening) and medical clearance establishing that I am capable of performing the easential functions of the position for which I am applying.
I understand that any iob offer is conditional and contingent upon satisfactory verification by Lyons Ambulance Service, LLC of the information I have furnished in this application.
I understand that any false representations, misrepresentations, or misleading statements made by me in this application, interview, or in connection with my physical conditlon and medical examination will be grounds for the rejection of this application or for rny dismissal.
I understand and agree that if my application is accepted, my employment may be terminated by me or by this company at any time with or without cause and without any liability on the part of the company for future wages, salary or benefits. l further understand that if accepted, my employment is at will and for no definite period and may be terminated without further notice and without liability for further salary.
I understand that it is unlawful in Massachusetts to require or adrninister a lie detector test as a condition of employment or continued ernployment. An employer who violates this law shall be subject to crimlnal penalties and civil liabilities.
I understand that any representations made by Lyons Ambulance Service, LLC in connection with this application for employment must be in writing by an authorized officer of the company.
I certify that I abstain form the abuse of drugs/alcohol which impair professional judgement and/or practice.
lf employed by Lyons Amhulance Ssrvice, LLC, I agree to abide by all company rules and regulations and to adhere to all company policies, procedures and diractives.
I certify that I am not listed on the OIG's list of Excluded lndividual/Entities for participation in federal health care prograrns.