Agency Employee Attestation Form for Hospitals

The mobile form includes fields to document items such as agency, employer, employee, start date and orientation date. Once the mobile app is filled out a secure PDF is generated. The PDF is easy to share, and a copy is stored in your account for your human resources records. You can also use the App Builder to personalize and customize this mobile form. Employment agencies and human resource departments can use the app to ensure that requirements have been met prior to placing an employee. A completed background check. A valid drug screen by on file with the contracting agency. Completed Form I‐9 (Employment Eligibility Verification) with two acceptable forms of employment eligibility documentation as reviewed and verified by our qualified staff. Work history and education verification. Two current employment references and/or performance evaluations, to be sent with the application. Licensure and/or certification, if applicable Health screen documentation on file with the contracting agency.