Authority To Release Information:
I consent to the release of information concerning my capacity and/or all aspects of prior job performance by employers, educational institutions, law enforcement agencies, and other individuals and agencies to duly accredited investigators, human resources staff, and other authorized employees of the state government for the purpose of determining my eligibility and suitability for employment. I certify that all statements made on this application and any attached papers are true and complete to the best of my knowledge. I understand that information on this application may be subject to investigation and verification and that any misrepresentation or material omission may cause my application to be rejected, my name to be removed from the eligible register and/or subject me to dismissal from state service. Confidentiality will be provided to the extent permitted under the Louisiana Public Records Act, La. R.S. 44:4.1 et. Seq.
As an applicant for LSU Health Shreveport, the information I have provided is accurate and complete to the best of my knowledge or belief. I understand the information provided may be verified by LSU Health Shreveport at a later time.
