Help. When you need it. 816-691-5101 Hospital
816-795-1445, Option 1 Outpatient Programs
913-228-5973 Valor Recovery Program

Complete Online Application

Personal Data


High School



Business / Trade / Technical

Employment History

(Please complete the following beginning with your most recent position and going back for 10 years including any military service — please account for any breaks in employment)

Position 1

Position 2

Position 3

Position 4

Skills / Training
Professional Registration / Licensure or Certification
Type State ID No. Expiration Date

By signing this application, and as an applicant for employment, I understand and certify the following:

  • The information given by me in this application is complete and true in all respects. Any omission, misrepresentation or falsification will preclude my application from further consideration. If employed, the subsequent disclosure of any omission, misrepresentation or falsification of information will result in the termination of my employment.
  • Nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between Signature Psychiatric Hospital and myself for either employment or for the providing of any benefit. No promises regarding employment have been made to me and I understand that no such promises or guarantees are binding upon Signature Psychiatric Hospital unless made in writing.
  • If I am offered employment by Signature Psychiatric Hospital, my employment will be for no definite term and that either I or Signature Psychiatric Hospital will have the right to terminate the employment relationship at any time, without cause and with or without notice.
  • If hired, I hereby give my consent to any post-offer drug or alcohol testing that may be required by the Company and authorize release of any such test results to Signature Psychiatric Hospital (CPH).
  • Signature Psychiatric Hospital will make all necessary and appropriate investigation to verify the information contained herein. I authorize and consent to my current and former employers, educational institutions and/or persons or organizations named in this application to release information to Signature Psychiatric Hospital that may be required to make an employment decision.
  • If I am offered employment, a criminal background check will be completed for employment purposes as appropriate to the position and upon my written authorization. I will have the right to make a written request for a complete and accurate disclosure.
  • If I am offered employment, my employment is conditioned on the provision of satisfactory proof of my identity and legal authority to work in the United States and the satisfactory completion of a preemployment drug screening for substance abuse.
  • Any employee handbook or other personnel policies maintained by Signature Psychiatric Hospital do not constitute an employment contract, but are merely gratuitous statements of Signature Psychiatric Hospital's current policies.

This application will remain active for a period of 90 days.

It is the policy of Signature Psychiatric Hospital to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability or any other legally protected status as required by federal or state law