Job Application
Personal Information
Fill Out Your Personal Information
Previous Education
Fill out the form below regarding your past education and military experience.
Previous Employers
Fill out the form below regarding previous work experience and employers.
Interested Job Position
Fill out the form below regarding desired job position.
Terms & Conditions
Please read all the terms and conditions below
- Personal Information
- Education Information:
- Previous Work
- Job Information
- Terms & Conditions
Personal Contact Information:
Additional Background Personal Information:
Have you ever been employed by this organization in the past?
Are you related to or in any way associated with any current or former employees of El Paso Pain Center, PA or Las Cruces Pain Center or any other of it's affiliates?
Do you have a valid driver's license?
I certify that I am a U.S. citizen, permanent resident, or a foreign national with authorization to work in the United States.
Can you submit verification of your legal right to work in the United States? (Proof of eligibility will be required upon employment.)
Will you now or in the future require sponsorship for employment visa status?
Education:
Do you have a High School Diploma/GED?
Did You Attend A University, Business/Trade College School?
Did you complete the course?
Military Experience:
Are you now or have you ever been in the Armed Forces?
Are you currently a member of the National Guard?
Are you the spouse pf a United States Active Duty Military member?
Work Experience (Please begin with your current, or most recent job held):
Work Experience 2:
Job Preferences:
Resume Upload. Please upload your most recent resume you have available.
Max. size: 32.0 MB
Reference #1:
Reference #2
Reference #3
Terms & Conditions
I agree and understand the following:
1. By signing this application, I authorize EPMed, and any of it’s subsidiaries, to conduct investigations, including verification of my prior employment and education. I authorize all schools I have attended and employers I have worked for to release all relevant information about me. I agree to hold any party, including EPMed, and any of it’s subsidiaries, harmless of any Claims of Liability resulting from these investigations related to the information herein provided.
2. If an offer of employment is made to me, it is conditioned on, among other things:
A. My ability to produce documentation establishing both my identity and employment authorization as required by law, and my completion of the employment verification form designated by the Immigration and Naturalization Service; B. My meeting the minimum age requirements of applicable law. (This applies to applicants under the age 18); C. My passing a drug test conducted by an independent laboratory selected by EPMed, or any of it’s subsidiaries. I understand that a negative drug test is a requirement of this offer of employment and hereby agree to waive any and all claims arising from the taking of or results of the drug test.
3. This application, any handbooks, policies, practices, procedures or an offer of employment do not individually or collectively constitute a contract of employment or guarantee of employment for any specific term. Employment with EPMed, and any of it’s subsidiaries, is at-will, which means that my employment can be terminated at any time by EPMed, and of EPMed’s subsidiaries, or by me, without cause or notice.
4. I represent and agree that no obligation owed to another party would prevent me from accepting employment with EPMed, or any of it’s subsidiaries. I further represent that no business or technical information which I know to be confidential, proprietary or private has been submitted in connection with my employment.
By typing my name below I am indicating a full and complete understanding that if I make false statements, fail to disclose information, or fail to provide all the information required, I may be disqualified from being employed or I may be dismissed in the event I become employed by EPMed or any of it’s subsidiaries.
I Agree To The Above Terms & Conditions:
Please check the highlighted fields.