The undersigned herby authorizes Physicians Ambulance or it's insurance agency EZ2Insure, or it's assigns, to obtain copies of consumer reports, including a motor vehicle report, pertaining to me for employment purposes, and for use in rating and/or underwriting insurance for which the above-named employer may apply, and any renewal thereof. I understand that in obtaining such consumer reports, a consumer reporting agency may be used.
I hereby authorize release to Physicians Ambulance information held by parties regarding my previous employment, conviction history, driving history, education or degrees earned, credit history in compliance with all federal and state laws, and hereby release any providers of such information from any liability for providing same. I understand this information may be reviewed initially and periodically by these parties prior to and during employment.
I understand this information is to be utilized as part of the employment process. I also authorize investigation into my worker's compensation claim history if a conditional offer of employment is made to me, in compliance with A.D.A. guidelines; so as to assure I am not being offered a position, which could aggravate a previous injury.
I hereby acknowledge that Physicians Ambulance used third party information and cannot guarantee the accuracy of any such information. I therefore release Physicians Ambulance, its agents, my employer or prospective employer and its agents from any and all liability arising out of any errors or omissions regarding this investigation into my background, and authorize the background investigate agency to proceed with this investigation and release the results.