Careers

Join our team and explore exciting career opportunities at the Center for Retina and Macular Disease.

Join Us

Outlined below are current job opportunities within our company.If you are interested and qualified for one or more opportunities, please submit your resume to:

[email protected] or (833) 609-0629 – Fax, Attention: Human Resources

Special Note: CRMD will only contact those candidates whose experience and skills seem to match the qualifications/requirements of the position.

Best Regards,
CRMD Human Resource Team

An Equal Opportunity Employer M/F/V/H, Drug Free Workplace

Application for Employment

"*" indicates required fields

It is the policy of Vitreous & Retina Consultants, P.A, DBA: Center for Retina and Macular Disease, to provide employment, training, compensation, promotion and other conditions of employment based on qualifications, without regard to race, color, religion, national origin, sex, age, veteran status or disability status or any other characteristic protected by law. You should also be aware that we may have a background check performed on applicants and that a physical examination, including a drug screen, is possible in the employment process or randomly as an employee.

Personal Information

Name*

First Last

Email Address*

Address*

Street Address City State ZIP

Telephone*

Are you 18 or older?*

Yes

If you are less than 18 years of age, please state your age:*

Are you eligible for employment in the USA?*

Yes

Proof of eligibility*

Max. file size: 2 MB.

(Proof of eligibility will be required)

Names of friend(s) or relative(s) employed by us:

*During the last 7 years, have you ever been convicted of a crime, excluding misdemeanors and traffic violation?*

Yes

If yes, describe in full:*

*A conviction will not necessarily bar you from employment

Employment Desired

Position Desired*

Part Time

Full Time

Either

Date you can start*

MM slash DD slash YYYY

Salary required*

How did hear of this job?

Currently Employed*

Yes

Can we contact your present employer?*

Yes

Are there any days you cannot work?*

Yes

If yes, which days?*

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

If required, can you work overtime?*

Yes

Education and Training

Please indicate highest grade and/or number of years completed in each school category

High School Name*

Location*

Years Attended*

Degree*

Major*

College Name*

Location*

Years Attended*

Degree*

Major*

Graduate School Name*

Location*

Years Attended*

Degree*

Major*

Technical or Other Name*

Location*

Years Attended*

Degree*

Major*

Military Service

Were you in the U.S. Armed Forces?*

Yes

If yes, what branch?*

Date of Duty (From)*

MM slash DD slash YYYY

Date of Duty (To)*

MM slash DD slash YYYY

Rank of Discharge*

Indicate duties or special training in the service*

Former Employees

(List below the last three Employers, starting with the most recent)

Employer 1:

Job Description

Telephone Number

Name of Supervisor

Address

Employed Date (From)

MM slash DD slash YYYY

Employed Date (To)

MM slash DD slash YYYY

Starting Salary

Ending Salary

Reason for Leaving

Employer 2:

Job Description

Telephone Number

Name of Supervisor

Employed Date (From)

MM slash DD slash YYYY

Employed Date (To)

MM slash DD slash YYYY

Starting Salary

Ending Salary

Reason for Leaving

Employer 3:

Job Description

Telephone Number

Name of Supervisor

Employed Date (From)

MM slash DD slash YYYY

Employed Date (To)

MM slash DD slash YYYY

Starting Salary

Ending Salary

Reason for Leaving

References

(Give the names of three people not related to you, whom you have known at least a year.)

Person 1 Name*

First Last

Address*

Telephone Number*

Years Acquainted*

Person 2 Name*

First Last

Address*

Telephone Number*

Years Acquainted*

Person 3 Name*

First Last

Address*

Telephone Number*

Years Acquainted*

Acknowledgement and Agreement

I certify that all statements given on this application are true and correct to the best of my knowledge. I agree that any false statements, misrepresentations or omissions of fact during the hiring process, may be grounds for denial of employment or if hired before discovery, my employment may be subject to termination.

I freely and voluntarily agree to submit to a drug test at any time as may be allowed by state or federal law as part of my application for employment and that any offer of employment is conditional upon passing said pre-employment testing. I also understand and agree that Center for Retina and Macular Disease reserves the right to require me to submit to an alcohol test and/or medical examination to the extent permitted by law. I further understand that refusal to submit to said drug and/or alcohol testing as are permitted by law, or the positive testing for prohibited drugs and/or alcohol in accordance with standards established by either state or federal law, may result in disciplinary action, including immediate suspension or termination of employment. Further, I understand that you may be requesting information from various federal, state, or other agencies which maintain records concerning my past activities relating to my driving, criminal, civil and other experiences.

I understand and agree that if hired, I have the right to resign my employment at any time, with or without cause and that my employment may be terminated with or without cause or notice. I understand that this acknowledgment supersedes any prior oral or written understanding.

I understand that Center for Retina and Macular Disease may contact my previous employers, unless otherwise stated, and I authorize employers to disclose all records and other information pertinent to my employment and release them from liabilities that may result from such disclosure.

Authorization*

I authorize, without reservation, any party or agency contacted by this employer to furnish the above-mentioned information.

Date

MM slash DD slash YYYY

Signature*

Max. file size: 1 MB.

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Careers

Join Us

An Equal Opportunity Employer M/F/V/H, Drug Free Workplace

Application for Employment

Personal Information

Employment Desired

Education and Training

Military Service

Former Employees

References

Acknowledgement and Agreement

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