I hereby certify that this application contains no willful misrepresentation and that the information given is true and complete to the best of my knowledge. I am aware that should investigation at any time disclose any such misrepresentation or falsification, my application may be rejected, my name may be removed from consideration, or if employed, I may be discharged from my employment.

I authorize my current or former employers and all schools or educational and technical institutions which I have attended to provide Cardiac Specialists representatives any information regarding my current or former employment, scholastic records or ratings. I hereby release any such current or former employers or institutions, their agents or employees from any and all liability resulting from the release of such information. My authorization and release from liability are voluntary acts. This authorization shall be effective for employment investigations by Cardiac Specialists and/or its agents.

Further, I understand that at time of hire, I will be required to provide documentation showing authorization to work in the United States. I further authorize Cardiac Specialists to check my credit and/or driving history and/or criminal background. I consent to submit to drug testing as a condition of initial or, if hired, continued employment with Cardiac Specialists.