APPLICATION FORM

Yes, I am interested in employment with Progressive Health Care Centers. I understand that I may attach a resume to this form after completing the information requested below. I acknowledge that this is not an employment application. I also understand that I will be required to complete an employment application if scheduled for an interview.



  • All licensed and/or certified positions require proof of current license and certification.

  • Only PDF, DOC, DOCX, RTF and TEXT files smaller than 2MB are accepted.
  • Only PDF, DOC, DOCX, RTF and TEXT files smaller than 2MB are accepted.

  • EEO Information (Voluntary)


  • I hereby certify that the information in this form (and any accompanying documents) is true and complete to the best of my knowledge. I understand that any misrepresentation or failure to disclose information on this form may result in my disqualification from further consideration for employment, or if employed, my termination. I understand that the satisfactory completion of a background check and drug screen (conducted after an offer of employment) is a condition of employment with Progressive Health Care Centers. DO NOT E-SIGN UNTIL YOU HAVE READ THE STATEMENT ABOVE. By my eSignature below, I certify that I have read, fully understand, and accept all terms of the foregoing statement. I consent to conducting this transction electronically, and I agree that my eSignature as the saem force and effect as my handwritten signature on this document.