Hospice of Davidson County
200 Hospice Way
Lexington, NC 27292
(336) 475-5444
We are an Equal Opportunity Employer.  Federal and state laws prohibit against discrimination on the basis of age, race, color, gender, national origin, religion and disability.  Applications are kept on file for 90 days.  After 90 days, applications are archived and you will need to complete a new application.  Please complete all fields.

Employment Application

Work Information

Can you submit proof of legal employment authorizations and identity? *
Do you have a valid NC driver's license? *
Shift preference - please select all that apply *
Hours preferred
Have you ever filled out an application with Hospice of Davidson County before?
Have you ever been employed with Hospice of Davidson County before? *
Have you ever been convicted of any unlawful offenses, other than minor traffic violations? *


Did you graduate?
Did you receive a degree or certificate? *
Did you receive a degree or certificate?
Are you attending school now?

Military Service

Were you a member of the U.S. Military Service?
Reserve status


Are you fluent in a foreign language?


Which of the following are you able to use proficiently?

Employment History

Check one
May we contact your employer?

Check one
May we contact your employer?

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May we contact your employer?



I certify that the answers given by me in the foregoing questions are true and correct without consequential omissions of any kind whatsoever.  I agree that my employer shall not be liable in any respect if my employment is terminated because of falsifying statements, answers or omissions made by me in this application.  If I am extended an offer of employment with Hospice of Davidson County, I understand I will be required to successfully pass a pre-employment screening.
I authorize Hospice of Davidson County to conduct or investigate the following pre-employment screening and test which may include but not be limited to:  drug test, criminal background check, motor vehicle record, education vertification, employment history, credit report and personal history.  I hereby release my employers, schools or persons named above from all liability for any damages, both legal and otherwise, for issuing this information.
I fully understand that if I fail any pre-employment screening or test, the offer of employment will be withdrawn.
If accepted for employment, I hereby agree to abide by the rules and policies of Hospice of Davidson County.  Further, I understand that any employment is not for a stated period of time and may be terminated with or without cause, at any time, at the option of either my employer or myself.
This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.