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Get Cleveland Clinic Background Information Release Form 2009-2025
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How to fill out the Cleveland Clinic Background Information Release Form online
Completing the Cleveland Clinic Background Information Release Form online is a crucial step in the employment process. This guide will assist you in accurately filling out the form, ensuring a smooth background check experience.
Follow the steps to successfully complete the form.
- Click 'Get Form' button to obtain the form and open it in the designated editor.
- Begin by reading the document carefully. Ensure you fully understand the authorization terms provided at the beginning. This section grants the Cleveland Clinic Foundation permission to contact relevant agencies for background checks.
- Next, indicate whether you have ever been convicted of or pled guilty to any criminal offense (excluding minor traffic offenses). Select 'YES' or 'NO'. If you choose 'YES', provide a brief explanation in the space provided.
- In the section regarding your employment consideration, specify whether you are applying for full-time, part-time employment, as a vendor, contractor, volunteer, or student.
- Enter your current employer's name (this should not be Cleveland Clinic), followed by your full name, social security number, and date of birth.
- Complete your address details, including city, state, and ZIP code. If applicable, fill out your visa or passport number.
- Provide the name and phone number of your supervisor or contact person from your current agency or company.
- Lastly, sign and date the form in the designated areas to confirm your authorization. Ensure all fields are completed accurately.
- Once you have filled out all necessary information, save your changes, and you may opt to download, print, or share the form as needed.
Complete your Cleveland Clinic Background Information Release Form online today!
Related links form
The fax number for sending medical records to Cleveland Clinic varies by department, so it is crucial to double-check the specific number for your case. When faxing, include the Cleveland Clinic Background Information Release Form to authorize the release of your medical records. For the most accurate information, visit the Cleveland Clinic's official website.
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