Employee Acknowledgement Form

EMPLOYEE ACKNOWLEDGEMENT FORM

The employee handbook describes important information about PMG, and I understand that I should consult the Personnel Department regarding any questions not answered in the handbook.

I have entered into my employment relationship with PMG voluntarily and acknowledge that there is no specified length of employment. Accordingly, either I or PMG can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.

Since the information, policies, and benefits described here are necessarily subject to change, I acknowledge that revisions to the handbook may occur, except to PMG's policy of employment-at-will. All such changes will be communicated through official notices, and I understand that revised information may supersede, modify, or eliminate existing policies. Only the Administrator of PMG has the ability to adopt any revisions to the policies in this handbook.

Furthermore, I acknowledge that this handbook is neither a contract of employment nor a legal document. I have received the handbook, and I understand that it is my responsibility to read and comply with the policies contained in this handbook and any revisions made to it.

I also acknowledge that I have been given the website to pull up this handbook: provmedical.com/handbook.

EMPLOYEE'S NAME (printed): _______________________________________________

EMPLOYEE'S SIGNATURE: _________________________________________________

DATE: __________________________________

POSITION: ______________________________

RATE OF PAY: __________________________

NOTE TO EMPLOYEE: This form is to be signed and submitted to the manager/physician before you receive your first paycheck. A copy will be filed in your personnel file.