Attestation Regarding Criminal History

NOTICE: By signing this Attestation Regarding Criminal History, I acknowledge that this form is an element of my employment application and personnel record and is therefore an official company record. I acknowledge that falsification of representations made on this form are just cause for termination of my employment, even if the underlying criminal history would not itself ordinarily have disqualified me from employment.

Henry Ford Health (HFH) will complete a criminal background check to confirm the accuracy of attestations provided below. By signing this Attestation Regarding Criminal History, I acknowledge that my employment with HFH is contingent upon completion of a criminal background check, notwithstanding that I may have started employment before completion of that criminal background check.