I understand that any false or misleading statements given by me to CCI may constitute grounds for my dismissal. I give CCI authority to contact references both listed and not listed by me in an attempt to perform a standard background check and investigation of both my professional and personal history. Either an original or photostatic copy of this authorization shall be valid.
I hereby release from liability all representatives of Correct Care Inc., the Hospital or its Medical Staff, or any 3rd party credentialing agencies for their acts performed in good faith and without malice in connection with evaluating my application, credentials and qualifications.
I also hereby release from any liability any individuals and organizations who provide information to the Hospital, or its Medical Staff, in good faith and without malice concerning my professional competence, ethics, character and other qualifications for staff appointment and clinical privileges, and I hereby consent to the release of such information.