Good Moral Attestation - Assist Medical Staffing

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ATTESTATION OF GOOD MORAL CHARACTER

To be signed by applicants who have accepted a conditional offer of employment and will begin work on a provisional basis after preliminary background check is, and pending the outcome of State or Federal fingerprint background results. A copy of this signed attestation must be kept in the conditional hire’s personnel file.

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I hereby attest I am of good moral character and I have not been convicted or found guilty of, or entered a plea of nolo contendere or guilty to, any misdemeanor or felony offense.
I hereby attest I am not disqualified from participation in Medicaid or Medicare programs and have not been sanctioned by any federal or state agency.
I hereby acknowledge my license/certification is in good standing with no pending or prior investigations.

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