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I certify that information contained in this application is true, correct and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future. If employed by Synergy HomeCare, I will comply with all rules and regulations of the company. I agree to submit to a physical or drug examination if requested. I authorize my former and current employers to give any information they have regarding me to Synergy--whether or not it is in their employment records. I also authorize Synergy to conduct any background checks necessary including, but not limited to: felony/misdemeanor convictions, previous arrest history, and driving records. I release all parties (including Synergy) from any and all liability and damage for issuing or procuring the same. I understand that if any fraudulent information is given on this application, it will be grounds for immediate termination. Synergy HomeCare is an Equal Opportunity Employer. I understand that Synergy's job positions are placed equally without discrimination because of race, creed, color, religion, sex, national origin, sexual preference, handicap, or age.
TERMS & CONDITIONS / NON-COMPETE AGREEMENT FOR CAREGIVERS
This agreement is between Synergy HomeCare and the applicant in which Synergy HomeCare and applicant agree to the following:
1. I understand that no staffing fees will be collected from me (the applicant) by Synergy HomeCare;
2. While I am a caregiver on assignment, I am an employee of Synergy HomeCare and I am not authorized to:
· Operate the client’s machinery, except standard office equipment,
· Render an opinion on behalf of Synergy HomeCare on the client’s financial statements, or sign my name to any fax returns,
· Handle cash, negotiables or other valuables without written permission from Synergy or may not transport or convey monies, securities or any negotiable instruments (including, but not limited to, delivering bank deposits to bank or other financial institution.)
3. I understand that registering with Synergy HomeCare is not a guarantee of employment.;
4. I can thoroughly and consistently perform all job duties (including lifting 25 pounds) without injury or concern;
5. I will notify Synergy HomeCare of any event that may prevent me from accepting or completing an assignment. If I am unable to complete my assignment, I will give Synergy HomeCare a minimum of one (1) week notice. I understand that if I do not report to an assignment and I do not contact Synergy HomeCare prior to the assignment start time, Synergy HomeCare may assume that I have voluntarily quit and I will no longer be eligible to work through or be represented by Synergy HomeCare;
6. Synergy HomeCare may provide me with opportunities and or job interviews in my field of caregiving. Synergy HomeCare shall, at its own expense, spend time and effort researching the job market and contacting potential clients, which efforts may result in resume presentation and or job interviews. In consideration for the services provided above, I agree that I will not directly solicit or seek employment from any individual or any contact associated with or referred by same, with whom Synergy HomeCare presents my resume to and/or arranges an interview with, and/or places me on assignment with, now or at any time during the twelve (12) months following my resume presentation, interview or assignment or twelve (12) following my discharge from employment. I understand if I do solicit and/or accept employment with any potential or current client/employers in which Synergy HomeCare has to within twelve (12) months of resume presentation, interview or assignment and do accept employment as either a permanent, contract or temporary position, an Employment Fee will be collected from me. This Employment Fee will be equal to the average monthly pay over the previous 3 months of your employment with the particular client or $2000 whichever is the greater amount.
Our employees are often placed in positions where they are required to handle information or work with procedures that are proprietary to our clients. Therefore, the applicant agrees to the following:
7. I understand the information I come in contact with is confidential and proprietary;
8. I will not at any time during my employment or any time thereafter publish, disclose, or utilize any confidential or proprietary information and material gained while working as an employee with any client;
9. I will protect the integrity of written records by storing and working with them in an appropriate manner, I will not copy any documents or portion of any document without specific instructions to do so.
10. I understand that as an employee of Synergy HomeCare I may be sent on assignments to clients that may have been previously serviced directly or indirectly by competitors of Synergy HomeCare. I will not disclose details of my work, pay, or other Synergy information with any client or other home care or home health company representative.
I have read and understand the Terms and Conditions/Non-Compete Agreement. I understand that they are applicable when I am employed by or represented by Synergy HomeCare. I will fully comply with these rules and requirements. Failure to do so may result in my immediate termination or removal from client assignments.