Background Check Disclosure and Authorization
Standalone consumer-report disclosure and authorization for direct clinicians before background screening is requested.
Review this official Serenium Healthcare legal document for the current platform, marketplace, and account experience.
Questions about privacy or support may be sent to support@sereniumhealthcare.com or contact@sereniumhealthcare.com.
Disclosure
Serenium LLC d/b/a Serenium Healthcare may obtain a consumer report about you from a consumer reporting agency for purposes related to your eligibility to access healthcare shift opportunities through the Serenium marketplace. The report may include identity verification, criminal history, sex-offender registry information, sanctions or watchlist information, and other legally permitted background information. An investigative consumer report involving personal interviews will not be obtained unless you receive any additional disclosure required by law.
Authorization
I authorize Serenium LLC d/b/a Serenium Healthcare and its authorized consumer reporting agency to obtain consumer reports about me for the purpose described above, including during my marketplace relationship where legally permitted. I understand that I may request the name and contact information of the consumer reporting agency and may dispute inaccurate information.
Applicant information
Full legal name: ______________________________________________ Other names used: _____________________________________________ Current address: ______________________________________________ City/State/ZIP: ________________________________________________ Date of birth: __________________ SSN: __________________________ Email: _________________________ Phone: ________________________
Signature
Signature: __________________________________ Date: ______________ This authorization should be presented separately from the Clinician Agreement. State and local notices must be supplied where applicable before screening.
These official Serenium Healthcare legal documents may be updated prospectively as the platform, law, and marketplace operations evolve.