American Health Associates is the premier long-term care clinical laboratory in the region, servicing over 4000 facilities. Additionally, AHA is one of the fastest growing independent labs in the nation, currently offering services in: Florida, Georgia, Ohio, Maryland, Michigan, Kentucky, Indiana, Illinois, Missouri, Mississippi, Pennsylvania, Delaware, North Carolina, South Carolina, Tennessee, and Virginia. By investing in state of the art technology and a skilled work force, we can offer a superior program focused on serving the long-term care industry.

Signet: Pre-Employment Screening

American Health Associates (THE COMPANY) Background Check Authorization Form

The information contained in this application is correct to the best of my knowledge. I hereby authorize THE COMPANY and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report. I understand that the scope of the consumer report/ investigative consumer report may include, but is not limited to the following areas: verification of social security number; 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, Ohio Bureau of Workers Compensation, birth records, and any other public records. I further authorize any individual, company, firm, corporation, or public agency (including the Social Security Administration and law enforcement agencies) to divulge any and all information, verbal or written, pertaining to me, to THE COMPANY 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 data received from other sources. I hereby release THE COMPANY, the Social Security Administration, and its agents, officials, representative, or assigned agencies, including officers, employees, or related personnel both individually and collectively, from any and all liability for damages of whatever kind, which may, at any time, result to me, my heirs, family, or associates because of compliance with this authorization and request to release. If I am hired, this authorization shall remain on file and shall serve as an ongoing authorization for you to obtain “reports” about me from Signet Screening Inc. at any time during my employment with THE COMPANY. I further understand I have a right to make a request to Signet Screening, Inc., upon proper identification, to request the nature and substance of all information in its files on me at the time of my request.