Apply Online - The Urology Clinic - Johnson City / Bristol, TN

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Bristol Location
350 Steeles Road, Suite 1
Bristol, TN 37620
(423) 844-6600

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Johnson City Location
2340 Knob Creek Rd, Ste 720
Johnson City, TN 37604
(423) 926-6112

Online Job Application

If you’d like to work with us, please fill out an application here.

The Urology Clinic is an Equal Opportunity Employer.

Personal Information
Name*
Current Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Previous Address (if at present address less than one year)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Email*
Are you at least 18 years of age?*
- Yes
- No
Can you provide documented proof of your identity and eligibility for employment in the U.S.?*
- Yes
- No
Examples: Driver's license, Social Security card, birth certificate, Immigration/Naturalization Service documents
Position
Position(s) applied for*
How soon could you report to work?*
Type of employment desired*
- Full-time
- Part-time
- Temporary
Rate of pay expected*
What days and hours, if part-time?
Have you applied for a job with us before?*
- Yes
- No
Have you worked for us before?*
- Yes
- No
How did you hear about us?*
- Employee Referral
- Former Employee
- Newspaper Ad
- High School Recruitment
- College Recruitment
- Walk-in
Personal History
Have you ever been bonded?*
- Yes
- No
Have you ever been refused a bond?*
- Yes
- No
If yes, state reason and date
Have you ever been convicted of a violation of the law except for a minor traffic violation?*
- Yes
- No
(A conviction will not necessarily disqualify you from employment.)
If yes, state date, court, and place where offense occurred.
Have you ever been discharged or requested to resign from a position?*
- Yes
- No
Are you employed now?*
- Yes
- No
If yes, may we contact your present employer?
- Yes
- No
Have you ever held a position of trust (handling money or confidential material)?*
- Yes
- No
If yes, please describe
Do you have any reason to believe that you would have difficulty meeting this company's work schedule?*
- Yes
- No
Education
School History
Type of School Name of School Address of School Courses Majored In Last Year Completed Graduated/Degree?

Please include any high school, college, post graduate or trade school you attended.
Work History
Prior Work Record
Employer Name Address Phone Immediate Supervisor Job Title/Duties Date Hired Date Left Starting Rate Ending Rate Reason for Leaving May we contact this employer?

Start with most recent or present employer and complete in full. You may enter up to 5 employers.
Please provide any additional information such as special skills, training, experience, equipment operation, or other qualifications you feel will be helpful to us in considering your application.
References
Name Address Telephone

Enter up to three. Do not list relatives or former employers.
Agreement and Certification
Please read carefully and check the box below to acknowledge that you agree with our application policies. You may be required to fill out a paper application if you are interviewed to provide a signature.

"I certify that the information given by me in this application is true in all aspects, and I agree that if the information given is found to be false in any way, it shall be considered sufficient cause for denial of employment or discharge. I authorize the use of any information in this application to verify my statements, and I authorize past employers, all references, and any other persons to answer all questions asked concerning my ability, character, reputation, and previous employment record. I release all such persons from any liability or damages on account of having furnished such information. I understand that a consumer credit report may be obtained."

I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between the company and myself or for either employment or for the providing of any benefit. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon the company unless made in writing. If an employment relationship is established, I understand that I have the right to terminate my employment at any time and that the company retains the same right."

"If I am offered employment, I agree to submit to a physical examination whenever requested, and I understand my becoming employed and/or my continued employment are subject to the results of any physical examination related to my job duties in accordance with company policies and procedures."

"I understand that if employed, policies and rules which are issued are not conditions of employment and that the employer may revise policies or procedures in whole or in part at any time."

I understand that this application will be kept on active file for 90 days from the date completed, after which time I would have to reapply in accordance with established company procedures."
I agree with the Agreement and Certification.*
- I agree

Save and Continue Later

Type of School	Name of School	Address of School	Courses Majored In	Last Year Completed	Graduated/Degree?

Employer Name	Address	Phone	Immediate Supervisor	Job Title/Duties	Date Hired	Date Left	Starting Rate	Ending Rate	Reason for Leaving	May we contact this employer?

Online Job Application

Personal Information

Position

Personal History

Education

Work History

Agreement and Certification