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Authorization for Release of Information & Records
I understand that in consideration of my application, an investigation will be conducted.
I authorize Wake Forest University Baptist Medical Center, through its agent, Investigative
Associates & Consultants, Inc., to conduct such an investigation and release
the organization and its agent, including its officers, employees, and representatives,
from all liability or responsibility for this investigation, which may include,
but not be limited to, the gathering of information regarding verification of prior
employment, references, consumer credit history, driving history, and any criminal
history which may be in files of any state, federal, or local criminal justice agencies
("investigative reports")
I further understand that at any time during the course of my employment, Wake Forest
University Baptist Medical Center through its agent, Investigative Associates &
Consultants, Inc., in accordance with all applicable state and federal law,
may obtain additional or supplemental investigative reports to be used in connection
with my retention as an employee at Wake Forest University Baptist Medical Center.
Moreover, I understand that I have the right to request, in writing, a complete
and accurate disclosure of the nature and scope of this investigation. I understand
that the information requested below regarding sex, race, date of birth, and maiden
name is for the sole purpose of gathering information accurately.