The Guidance Center

Psychiatrist
Southgate, MIPsychiatric Services
Information
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Work History

Employment History: Beginning with the most recent employer, list all employment in the past ten (10) years. All information must be completed and all periods of time must be accounted for.

Work History 1
Education History

Professional License Held: If you hold any professional licenses in the State of Michigan, please list them.

Education History 1
Acknowledgements

An Equal Opportunity Employer


The Guidance Center is an Equal Opportunity Employer. It is the policy of The Guidance Center to afford equal employment opportunity regardless of race, religion, color, citizenship, national origin, sex (including pregnancy and conditions related to pregnancy), age, marital or veteran status, height, weight, disability, genetic information, sexual orientation, gender identity, transgender status, misdemeanor arrest record, or any other characteristic protected by law.

Equal Employment Opportunity

This information is collected in compliance with government record-keeping requirements. It is completely optional for you to submit and will be used only for Equal Employment Opportunity reporting and statistical purposes. It is not viewed or used as a part of the recruiting or hiring process.

Prior Convictions
Work Authorization
In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.
Acknowledgement
By submitting your application you hereby certify that the facts set forth in the above employment application are true and complete to the best of your knowledge.

By submitting your application you hereby certify and affirm that the facts set forth in your employment application and resume and stated during any interview are and shall be true and complete to the best of your knowledge and that I have not withheld any information that would affect my application unfavorably. I authorize the Guidance Center to conduct any necessary and reasonable investigation with respect to my application. I release The Guidance Center, my former employers and personal references from any liability or damages which may result from giving information that is lawful to provide or the receipt of such information concerning my prior employment, my character or my employment potential. It is understood that any false, misleading or incomplete statement made by myself in the application, on my resume, or during the interview process or my employment shall be considered sufficient reason for rejection of my application, or dismissal if subsequently employed by the Guidance Center.


The filing of an application with The Guidance Center is a preliminary step to employment. This does not obligate The Guidance Center to offer employment or the applicant to accept employment. An offer of employment, if made, is for at will employment and is not to be construed as a guarantee of continued employment for any specific duration. This means The Guidance Center reserves the right to terminate the employment of any employee at any time without cause. This “at-will” term can only be changed in a writing entitled “Employment Agreement” and signed by the Chief Executive Officer or by Collective Bargaining Agreement. I understand that, as an at-will employee, The Guidance Center has the right to change my employment terms, compensation, benefits, and position at any time upon reasonable notice unless prohibited by a Collective Bargaining Agreement. I further agree that, if I am employed by The Guidance Center, I shall conform to its rules, policies and regulations as they now exist or as they are hereafter implemented or modified. 


I understand that, after receiving an offer of employment (and at any time thereafter), The Guidance Center may require the successful completion of a drug test and/or a blood alcohol test as a condition of employment. By submitting this Application for Employment, I hereby consent to either or both tests, at the sole discretion of The Guidance Center, and agree that testing positive or refusing any such test constitutes sufficient reason for terminating my employment.


Under Michigan law only, any individual who has a disability and requires an accommodation to complete the hiring process or to perform the essential functions of the position sought must request the accommodation in writing within 180 days of the day he or she knows or should have known of the need. A person with a disability requiring accommodation for completing the application process should notify the Human Resource Department for assistance at the address above or 734-785-7700.


I agree that, to the extent permitted by law, any action or suit against The Guidance Center or related entities (or any of its or their employees, officers, directors or representatives), which arises out of my employment or termination, including, but not limited to, claims arising under state or federal civil rights statutes, must be brought within 180 days of the event giving rise to the claim or be forever barred. To the extent permitted by law, this applies to the initial filing of a charge with the Equal Employment Opportunity Commission; however, thereafter I am permitted to pursue litigation, if I so choose, as explained in the Commission’s “Right to Sue” letter. I waive any longer, but not shorter, limitations periods to the contrary. Should any court having proper jurisdiction determine that this contractual limitations period is unenforceable as to one or more claims, it shall have the authority to revise this term to the extent necessary, so that it can be enforced as to all other claims asserted in order to achieve the intent of the parties.


If any term above is deemed unlawful and unenforceable, it may be severed and the remainder shall be fully enforceable. I accept the terms above knowingly and voluntarily.


E-Verify
The Guidance Center participates in E-Verify, the federal program for electronic verification of employment eligibility. Learn More

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