We are required to complete background checks on all employees. Please complete the following information.

A Health Care Worker registry check is required by Illinois law and/or the Agency. An applicant / employee for any position in our Agency shall not be hired and may be terminated if the Health Care Worker registry report indicates such person is identified as having substantiated findings of abuse, neglect, egregious neglect or financial exploitation. There is no charge for this registry check. Please complete the following information:

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that this application is not intended to be a contract of employment, and further, that if employed, my employment is on an at will basis and may be terminated at my discretion or at the discretion of Pathway Services Unlimited.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in dismissal from employment.

I hereby give permission to check on the information provided in this form.

Please review the document below in it’s entirety. You can also choose to download or print this document for your own records.

POLICY

The unlawful manufacture, distribution, dispensation, possession, use, sale or transfer of alcohol, cannabis, a controlled substance, or illegal drugs and any drug related paraphernalia and/or illegal use of controlled substances by Pathway employees, contractual employees, and/or volunteers and/or being under the influence of same while at work or while providing volunteer services, is inconsistent with Pathway’s commitment to a healthy workforce and a safe and productive work environment for employees, visitors, volunteers and individuals who receive services from the Agency. Pathway is committed to maintaining a safe and drug-free workplace.

This policy applies to all applicants being considered for employment by the Agency and contractual employees and/or volunteers who have contact with individuals receiving services from our Agency (e.g. interns or student volunteers). Pathway requires all applicants considered for employment, contractual employees and volunteers as previously described to authorize and complete a drug screen test, the results of which will be submitted to Pathway. Signature on the application for employment, on the employment contract, or on the volunteer application indicates the applicant’s / contractual employee’s / volunteers’ consent to this policy. Applicants who refuse to sign a separate acknowledgment / consent / release form will not be hired. Potential contractual employees who refuse to sign a separate acknowledgement / consent / release form will not be considered for a contractual position. Volunteers who refuse to sign a separate acknowledgment/ consent / release form will not be considered for a volunteer position.

Applicants, prospective contractual employees, and/or prospective volunteers who refuse to take the drug screen test, who fail to keep the appointment for the same, who refuse to cooperate or comply with procedures for the test(s) in any way (including those whose samples and/or tests are altered, switched or tampered with), or who are found as a result of the test(s) to have: i) any detectable level of an illegal drug, ii) any detectable level of a drug indicating illegal use of a controlled substance and/or a synthetic substance, will not be tolerated and will preclude the applicant, potential contractual employee, and/or prospective volunteer from further consideration.

PURPOSE

To promote employee health and a safe and productive environment for employees, visitors, volunteers, and individuals who receive services from the Agency. All employees and volunteers of the Agency are considered to hold “safety sensitive” positions, which are defined as positions which are responsible for the health and safety of others.

PROCEDURES

1. The Application for Employment or Volunteer Application, and / or a separate Acknowledgment/Consent/Release form will be signed by each applicant for employment, contractual employee, and/or prospective volunteer, indicating the applicant’s agreement to abide by this policy.
2. Each applicant considered for employment, contractual employee, and/or prospective volunteer will be sent to a medical facility for the scheduled screening and directed on procedures at that time. Full and prompt cooperation is required.
3. The results of the drug screen test will be sent by the medical facility to the Agency’s Human Resources Director or designee.