Any doctor, hospital or testing laboratory has my consent to conduct medical or drug test on me, and I hereby
give my consent to having all information released for GNS to determine my abilities to perform job duties now or in the future.
I understand that GNS requires all staff to report sanction, convictions, suspensions, censures or revocation action taken
against them by federal, state, local, or other professional entities. These sanctions may include but not limited to infractions against professional licensure, criminal history convictions,
history of child abuse, managed care organization, etc.