APPLICATION

Find job openings and health care career opportunities in Tucson at Southern Arizona Urgent Care.

READ BEFORE SENDING
All applicants MUST fill out and submit the Employment Application corresponding to the position along with resume.

What position are you applying for?*

Position Desired:*
Our Hours of Operation are 7:00am to 7:00pm
What is your availability?*






How did you hear about us?*
First Name*
Middle Initial
Last Name*
Gender*
Nick Names
Degree*
Full Address*
Email*
Phone Number*
City of Birth*
State of Birth*
Country of Birth*
Citizenship*
Are you eligible to work in the US?*
ACTIVE or RESERVE military duty?
Military Branch
Languages Spoken*
Have you ever been employed with Southern Arizona Urgent Care?*

Start Date
End Date
If yes, please state the reason for leaving.*
Have you ever been convicted of a crime?*

If yes, explain number of conviction(s), nature of offense(s), how recently offense(s) was/were committed, sentence(s) imposed, and type(s) or rehabilitation.*

WORK HISTORY

Please list your last three employers if applicable. "See Resume" is not acceptable.

EMPLOYER 1

Would you like to fill out this section?*

Employer Name
Start Date
End Date
Rate of Pay
Job Title
Phone
Street Address
Suite
City
State
Zip
Supervisor Name
Supervisor Phone Number
Reason for Leaving and an explanation for any breaks in employment.

EMPLOYER 2

Would you like to fill out this section?*

Employer Name
Start Date
End Date
Rate of Pay
Job Title
Phone
Street Address
Suite
City
State
Zip
Supervisor Name
Supervisor Phone Number
Reason for Leaving and an explanation for any breaks in employment.

EMPLOYER 3

Would you like to fill out this section?*

Employer Name
Start Date
End Date
Rate of Pay
Job Title
Phone
Street Address
Suite
City
State
Zip
Supervisor Name
Supervisor Phone Number
Reason for Leaving and an explanation for any breaks in employment.

EDUCATION

Please list your highest education first.

EDUCATION 1

Would you like to fill out this section?*

Education Type
Institution Name
Start Date
End Date
Degree
Completed Degree?
City
State
Country
Comments

EDUCATION 2

Would you like to fill out this section?*

Education Type
Institution Name
Start Date
End Date
Degree
Completed Degree?
City
State
Country
Comments

EDUCATION 3

Would you like to fill out this section?*

Education Type
Institution Name
Start Date
End Date
Degree
Completed Degree?
City
State
Country
Comments

REFERENCES

A reference cannot be a family member. Two professional references are required.

REFERENCE 1

First Name*
Last Name*
Phone Number*
How do you know this person?*

REFERENCE 2

First Name*
Last Name*
Phone Number*
How do you know this person?*

REFERENCE 3

First Name
Last Name
Phone Number
How do you know this person?

APPLICATION ACKNOWLEDGEMENTS

  1. I certify that the information provided herein is true and correct to the best of my knowledge. I understand that, if employed, falsified statements on this Application for Employment form will be considered grounds for termination. I hereby authorize Southern Arizona Urgent Care, LLC and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or investigative report to be generated for employment and/or volunteer purposes. I understand the scope of the consumer report/investigative consumer report may include, but is not limited to the following areas: verification of social security number, credit reports, current and previous residences; employment history, education background, character references; drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions; driving records, birth records and any other public records. I further authorize any individual, company, firm, corporation, or public agency to divulge any and all information, verbal or written pertaining to me to Southern Arizona Urgent Care, LLC or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation or public agency may have, to include information or date received from other sources. Southern Arizona Urgent Care, LLC and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicants’ personal information, including, but not limited to, addresses, social security numbers, and dates of birth.
  2. Federal law requires that employers hire only individuals who are authorized to be lawfully employed in the United States. In compliance with these laws, Southern Arizona Urgent Care will verify the status of every individual offered employment with Southern Arizona Urgent Care. In this connection, all offers of employment are subject to verification of the applicant’s identity and employment authorization, and it will be necessary for you to submit such documents as are required by law to verify your identification and employment authorization.
  3. My signature attests to the fact that the information that I have provided on my application, resume, given verbally, or provided on any other materials, is true and complete to the best of my knowledge and also constitutes authority to verify any and all information submitted on this application. I understand that any misrepresentation or omission of any fact in my application, resume or any other materials, or during any interviews, can be justification for refusal of employment, or, if employed, termination from Southern Arizona Urgent Care’s employ.
  4. Southern Arizona Urgent Care or its agents may seek to verify the information on this application. As such, I hereby authorize Southern Arizona Urgent Care or its agents to contact any former employer or any representative of any other organization to which I have made reference in this application, and I hereby authorize said employer and/or representative to provide information to Southern Arizona Urgent Care on my behalf.
  5. I understand that this application is not an employment contract for any specific length of time between Southern Arizona Urgent Care and me, and that in the event I am hired, my employment will be “at will” and either Southern Arizona Urgent Care or I can terminate my employment with or without cause and with or without notice at any time. Nothing contained in any handbook, manual, policy and the like, distributed by Southern Arizona Urgent Care to its employees is intended to or can create an employment contract, an offer of employment or any obligation on Southern Arizona Urgent Care’s part. Southern Arizona Urgent Care may, at its sole discretion, hold in abeyance or revoke, amend or modify, abridge or change any benefit, policy practice, condition or process affecting its employees.
Your Signature*
(SAUC will accept a typed name as your signature.)


Comments
ATTACH RESUME, 7 YEAR CV AND OTHER DOCUMENTS

MAX UPLOAD SIZE: 8MB total

PDF file format is preferred but the following are also accepted formats:

  • doc
  • docx
  • rtf
  • jpg

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