I, me the undersigned employee/nurse/contractor, authorize Caring Hands Incoporated to release any or all information contained within my personnel file, including my professional and medical information to any medical facility or entity with whom Caring Hands Incoporated has contracted to receive services and any regulatory or governmental agency upon request. I authorize Caring Hands Incoportated to conduct background investigations of my activities, education, and employment. I further agree to submit an initial drug screen, as well as random alcohol and drug screens as needed and as required for the purpose of performing any skilled nursing procedures with Caring Hands Inc. I understand Caring Hands Inc may make the decision to release any and all information at its discretion, providing such a release is made to authorized representatives or appropriate entities as described. I understand that in all other cases, my records and file will remain confidential and will only be released with my written authorization My signature hereunder indicates that I have read and understood this release form in its entirety Name of employer: Caring Hands Devotional Home Care Agency, Inc