Employment Application

PRN Medical Transport

Employment Application Packet

TO: All Applicants
FROM: PRN Management

Thank you for expressing an interest in PRN Medical Transport.

PRN Medical Transport provides non‐emergency medical transportation for patients of several nursing facilities and private residents throughout the Burlington and Camden County areas.

Our services include both wheelchair and stretcher transportation for many reasons, such as but, not limited to: Emergency Room visits, Doctor's Office visits, physical therapy, dialysis treatments, etc.

General Requirements for employment:

  1. All applicants must be at least eighteen (18) years of age prior to starting work for PRN.
  2. All applicants must have a valid driver's license.

Emergency Medical Technician (EMT) requirements:

  1. All applicants must have a valid CPR for the Professional Rescuer certification.
  2. All applicants must be certified as a NJ EMT, National Registry EMT, or be certified as an EMT in a State in which NJ honors.

Full Time Employment:

An employee who is regularly scheduled to work at least 32 hours/week is a regular full‐time employee. Full‐Time employees are responsible for at least one On‐Call per week.

Part Time Employment:

An employee who is regularly scheduled to work less than 32 hours/week but at least 24 hours/week is a part‐time employee. Part‐Time employees are not eligible for benefits except as required by law or as provided by a specific PRN policy, or applicable plan document.

Per Diem Employment:

An employee who is hired to perform services to PRN on a basis other than a regular schedule. Per Diem employees are not eligible for benefits except as required by law, or as provided by a specific PRN policy, or applicable plan document. Per Diem employees must maintain an availability schedule with the dispatch center. Per Diem employees are required to be available to work a minimum of sixteen (16) hours during each calendar month.

Instructions for completing this application:

  1. Complete all information that is requested. If a questions does not apply to you write "N/A".
  2. Be sure to sign the "Authorization to Release Information" and the Employment Application.
  3. Include a copy of your driver's license and any certification you hold, such as a CPR or EMT card.
    *We can make copies at our office when you come to drop off your application.

All certifications must be valid and a copy must be provided to PRN Medical Transport.

AUTHORIZATION AND RELEASE TO OBTAIN INFORMATION FORM

As part of our hiring background and investigation, we may obtain consumer reports to prepare an investigative consumer report. The investigative consumer report may consist of contacting all listed prior employers to verify your employment history. It may also include, but not be limited to, credit information reports, criminal history reports and driving history records. Under the provisions of the Fair Credit Reporting Act (15 USC at 1681‐1681u) as amended, before we can seek such reports, we must have your written permission to obtain the information. You have the right, upon written request, to a complete and accurate disclosure of the nature and scope of the investigation. You are also entitled to a copy of your Rights Under the Fair Credit Reporting Act.

Under the provisions of the Fair Credit Reporting Act, 15 USC, Section 1681 et seq., the Americans with Disabilities Act and all applicable federal, state, and local laws, I hereby authorize and permit Care Medical Transportation INC. D/B/A PRN MEDICAL TRANSPORT to obtain a consumer report and/or an investigative consumer report which may include the following:

  1. My employment records;
  2. Records concerning any driving, criminal history, credit history, civil record, workers’ compensation (post‐offer only) and
    drug testing;
  3. In accordance with the Department of Transportation Motor Carrier Safety Regulations, Section 382.413, information concerning alcohol and controlled substances for the past 2 years;
  4. Verification of my academic and/or professional credentials; and information and/or copies of documents from any military service records.

I understand that an “investigative consumer report” may include information as to my character, general reputation, personal characteristics, and mode of living which may be obtained by interviews with individuals with whom I am acquainted or who may have knowledge concerning any such items of information.3

I agree that a copy of this authorization has the same effect as an original.

I hereby release and hold harmless any person, firm, or entity that discloses matters in accordance with this authorization, as well as Care Medical Transportation INC. D/B/A PRN MEDICAL TRANSPORT from liability that might otherwise result from the request for use of and/or disclosure of any or all of the foregoing information.

I understand and acknowledge that under provision of the Fair Credit Reporting Act I may request a copy of any consumer report from the consumer reporting agency that compiled the report, after I have provided proper identification.

I hereby authorize Care Medical Transportation INC. D/B/A PRN MEDICAL TRANSPORT to obtain and prepare an investigative consumer report as set forth above, as part of its investigation of my employment application. This authorization shall remain in effect over the course of my employment. Reports may be ordered periodically during the course of my employment.

Employment Application