Are there any reasons for which you might not be able to perform the job duties? (with a reasonable accommodation) Can you lift more than 25 pounds?

Working weekends is a requirement. Are you available to help out every other weekend; either a Saturday or a Sunday?

Are you fully Vaccinated from COVID-19?

Were you referred by an existing Always Best Care Employee?

Please list 3 professional references. Name, Phone & Email. :

Drug Test Required. I acknowledge that the specimen will be tested in my presence for Cocaine, Methamphetamines, Morphine, Benzodiazepine (BZO), OXY and Amphetamine (AMP) Please list any prescription medication you are taking:

For Employment purposes: What is your T-Shirt Size? :

Background and Release of Information I hereby authorize Loy Enterprises Inc. dba Always Best Care Senior Service at 2260 S. Church Street Suite 303 Burlington, NC 27215 to thoroughly investigate my background, references, employment record and other matters related to my suitability for employment. I authorize persons, schools, my current employer (if applicable) and previous employers and organizations contacted by Loy Enterprises Inc. dba Always Best Care Senior Service or their agent to provide any relevant information regarding my current and/or previous employment and I release all persons, schools, employers or any and all claims for providing such information. I understand that misrepresentation or omission of facts may result in rejection of this application, or if hired, discipline up to including dismissal. I understand that I may be required to sign a confidentiality and o r non-compete agreement should I become an employee of Loy Enterprises Inc. dba Always Best Care Senior Service Furthermore, Always Best Care may share all employment documentation with clients, subsidiaries, customers, affiliated, and government agencies to send me employment opportunity related information at fax or email addresses listed in this application. Always Best Care is an equal opportunity employer. Applicants are considered and hired without regard to race, sexual orientation, gender, age, color, religions, national origin, citizenship status, political affiliation or disability. In-Office Drug Screen Consent Form I authorize the collection of this urine specimen for the purpose of a drug screen. I acknowledge that the specimen will be tested in my presence for Cocaine, Methamphetamines, Morphine, Benzodiazepine (BZO), OXY and Amphetamine (AMP)that the information provided on this form is correct. I understand that taking legally prescribed medication that might impair mental or physical functions must notify management prior to reporting to work and/or prior to taking after the start of work. I understand I must show proof of legally prescribed medication to Always Best Care. I understand that this is only a screening test and that further confirmation by a reference laboratory will be necessary if results are not negative. I authorize the collector to send the specimen to the reference laboratory for confirmation if my specimen is not initially screened as negative. I authorize Always Best Care to release the results of the test to the employer identified on this form, or its designated agents. I understand that the medical personnel performing the screening test cannot answer questions or discuss the preliminary drug screen results or methods used. Final test results will be made available to me and I will have an opportunity to discuss them with the medical director, if necessary. I understand if the specimen comes back positive. I have the right to choose to send the specimen in for retesting at American Screening Corporation within 3 days. It is my responsibility to pay $25 in advance per each screening panel before Always Best Care sends the specimen to American Screening Corporation for retesting I understand that Always Best Care employees will be subject to "random/for cause" post-accident testing if involved in an on-the-job accident, near-miss accident, or an incident where injury or property damage did occur or might have occurred. Employees will be subject to "random/for cause" (reasonable-suspicion) testing when the problem exists, or a violation of the policy has occurred. I understand that nothing contained in this application or conveyed during any interview which may be granted, is intended to create an employment contract. I understand that filling out this form does not indicate there is a position open and does not obligate If Loy Enterprises Inc. dba Always Best Care Senior Service to hire me. I understand and agree that my employment is at will, which means that it is for no specified person and may be terminated by me or If Loy Enterprises Inc. dba Always Best Care Senior Service at any time without prior notice for any reason.