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  • Cardiology of Virginia, Inc. - Employment Application

    13572 Waterford Place, Midlothian, VA 23112 (804) 560-8782

  • It is the policy of Cardiology of Virginia Inc. to provide equal employment opportunities
    to all applicants and employees without regard to any legally protected status such as
    race, color, religion, gender, national origin, age disability or veteran status.

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  • Emergency Contact Information

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  • Applicant Employment History

    List your current or most recent employment first or upload resume.
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  • Applicant’s Education and Training

  • Professional References

    List any two people who have knowledge of your professional experience and skills.
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  • Personal Reference

    List someone (not a family member) who has knowledge of your personal character.
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  • Certification

  • I certify that the information provided on my application is truthful and accurate.

    I understand that providing false or misleading information will be the basis for
    rejection of my application, or if employment commences, immediate
    termination.

    I authorize Cardiology of Virginia, Inc. to contact former employers and
    educational organizations regarding my employment and education. I authorize
    my former employer and education organizations for fully and freely
    communicate information regarding my previous employment, attendance, and
    grades. I authorize those personals designated as references to fully and freely
    communicate information regarding my previous employment and education.
    If an employment relationship is created, I understand that unless I am offered a
    specific written contract of employment signed on behalf of the organization by
    its Human Resources Manager, the employment relationship will be entirely
    voluntary in nature. In other words, with appropriate notice, I will have the full
    and complete discretion to end the employment relationship when I choose and
    for reasons of my choice. Similarly, my employer would have the same right.
    Moreover, no agent, representative, or employee of Cardiology of Virginia, Inc.
    except in a specific written contract of employment signed on behalf of the
    organization by its Human Resources Manager, has the power to alter or vary
    the voluntary nature of the employment relationship.

    I understand that should an employment offer be extended to me and accepted
    that I will fully adhere to the policies, rules and regulations of employment of the
    Employer.

    Should I become employed, I release Cardiology of Virginia, Inc. to provide
    information of any kind or nature regarding my employment to future
    prospective employers and any legal authorities. I hereby release Cardiology of
    Virginia, Inc. from any and all liability of whatever kind and nature which, at any
    time, could result from providing such information, including, but not limited to
    the prospective employer declining to hire me based upon such information.
    I further agree to immediately notify Cardiology of Virginia, Inc. if I should be
    convicted of a felony, or any crime involving dishonesty or a breach of trust while
    this application is pending or during any period of employment, should I become
    employed.

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