Skip to content
CALL: (219) 322-7041
NOTE: occasionally, due to VOIP phones, if there is a Comcast outage you may be unable to call us.
Search for:
Home
About
Services
PEMF Therapy
Blood Tests
Common Hormone Tests
Common Thyroid Tests
Common Heart Tests
Allergy Testing
DNA Paternity Test
Drug Testing Hair
EKG
Fecal Occult Blood Test (Colon Cancer)
Hair Mineral Analysis
Immunizations and Shots
Urinalysis
On-site Appointment Calendar
Monthly Specials
Flash Sale
Job Application
Contact
Social
Job Application
Home
/
Job Application
Job Application
wp_admin
2024-04-22T14:22:59+00:00
Healthchek Employment Application Form
Step
1
of
6
16%
This application is current only for 60 days at the conclusion of which time, if you have not heard from us and still wish to be considered for employment, it will be necessary for you to fill out a new application. All employees of Healthchek may be required to pass a pre-employment drug test, a background investigation, and successfully complete a 90-day probation period.
Your Personal Information
Your Name
First
Last
Your Email Address
Enter Email
Confirm Email
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Home Phone
Cell Phone
Best Time To Call You
When is the best time for us to reach you via telephone?
Mornings
Early Afternoon
Late Afternoon
Early Evening
Position You're Applying For
Position Desired
Shift Preferred
Day
Swing
Graveyard
Any
Desired # of Hours
Full-Time
Part-Time
Either
Willing to Work Overtime?
Yes
No
Have you ever worked at Healthchek before
Yes
No
If so, dates
Have you ever been convicted of any crime other than a minor traffic violations
(Note: A yes response will not necessarily preclude you from employoment)
Yes
No
If so, list the nature of offense
Education / Job Skills
High School Diploma or GED
Yes
No
Education
College: Name/Address
Credits/Semester Hrs
Years Completed
Degree Yes/No
Add
Remove
Job Related Specials Skills and Qualifications
(Summarize special job-related skills, qualifications and certificates acquired from employment, education or other experience)
Employment History
Give the name, address and telephone number of three references who are not related to you, or former supervisors.
May we contact your current employer?
Yes
No
May we contact your previous employers?
Yes
No
Your Previous Employers
Please list your previous employers, the dates you worked and the position you held
Employer
Dates
Title
Phone
Salary/Wage
Supervisor's Name
Job Duty
Add
Remove
References
Begin with current or most recent employer. Please make sure you list all employment related to the position in which you are applying for.
Reference
Name
Address
Phone
Add
Remove
Application Statement
My prior employers, educational institutions, and other references listed on this application are authorized to give Healhchek any and all information concerning my previous employment, and any pertinent information. I release all persons and entities from any and all liability for any damage that may result from furnishing the information to Healthchek. I, also, release Healthchek and Healthchek employees from liability for any damage that may result from reliance on the information furnished. I certify that to the best of my knowledge, all of my statements are true, correct, complete and made in good faith. I understand that any false statement on this application may result in not being interviewed or hired. I understand that neither this application nor any written personnel procedure manual or employee handbook is an express or implied contract of permanent employment. I further understand that my relationship with Healthchek is "at-will" and for an unspecified term and that Healthchek and I each have the right to terminate the empolyment relationship at any time - with or without cause or advance notice. I have had an opportunity to have my questions about this statement's content and intent answered and understand it's terms.
Upload Your Resume
Upload your resume in .pdf, .doc or .docx format
Accepted file types: pdf, doc, docx, Max. file size: 25 MB.
Comments
This field is for validation purposes and should be left unchanged.
Δ
Go to Top