MARIO R. ANZALDUA, M.D.

Employment Application

Education, Licenses & Certifications

Healthcare Skills & Experience

Employment History

Professional References

Additional Information

Background Check Disclosure & Authorization

Disclosure: As part of the employment process, Mario Anzaldua, M.D., P.A. may obtain a consumer report and/or investigative consumer report about you for employment purposes, as permitted by applicable law. Such a report may include information regarding criminal history, employment history, education, professional licenses or credentials, and other job-related background information. If a consumer reporting agency is used, additional notices or forms may be provided as required by federal, state, or local law. This authorization does not guarantee that a background check will be ordered and does not constitute an offer or contract of employment.

Authorization: I acknowledge that I have read and understand the disclosure above. I voluntarily authorize Mario Anzaldua, M.D., P.A. and its authorized agents, where permitted by law, to obtain background information about me for employment purposes. I authorize employers, schools, licensing bodies, and other lawful information sources to release relevant information for this purpose, subject to applicable law.

Applicant Certification

I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that false or misleading information may result in disqualification from consideration or termination if hired. I authorize Mario Anzaldua, M.D., P.A. to verify my employment history, education, licenses/certifications, and professional references as permitted by law. I understand that submitting this application does not create a contract of employment or guarantee employment.

Résumé & Supporting Documents