PPSAT is committed to the health and wellbeing of all staff and patients. For this reason, we've made the decision that all PPSAT personnel are required to be vaccinated against COVID-19, unless a reasonable exemption is approved. All job offers will be contingent on the applicant’s ability to attest to being fully vaccinated post offer but prior to the start date. Are you willing and able to meet this job requirement with or without an exemption? If you attest that you have been vaccinated for COVID 19 you will be asked to submit a copy of your vaccination card if offered employment.✱

I understand that when requesting a medical or religious exemption the offer of employment is contingent upon the completion and approval of the exemption request form. I also understand that the completion of the exemption request form does not automatically exempt you from the mandated vaccine requirement. Once we are in receipt of the exemption request form a member of the Organizational Development team will contact you to discuss your request.✱

Were you referred to PPSAT for possible employment?✱

Do you have any family members currently employed by PPSAT? Family members may include: partner, spouse, child, legal guardian, parent, sibling, aunt, uncle, niece, nephew, cousin, grandparent, grandchild, in-law, or step relative.✱

I have given Planned Parenthood South Atlantic true and complete information on this application. I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give Planned Parenthood South Atlantic permission to contact previous employers, references, and others, and hereby release Planned Parenthood South Atlantic and its employees, directors and officers from any and all liability as a result of such contact. I acknowledge that all employment at Planned Parenthood South Atlantic is at-will. I understand that a job offer is contingent upon an investigative background check that may include information as to my criminal records, driving records, credit records, character, social media accounts, and general reputation.✱