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Former Employer Release Form

1) TO EMPLOYER/FORMER EMPLOYER:

DUE TO THE PRIVACY ACT, MOST EMPLOYERS ARE NO LONGER COMPLETING REFERENCE REQUESTS WITHOUT THE EXPLICIT PERMISSION OF THE INDIVIDUAL INVOLVED. THEREFORE, I AM GRANTING YOU PERMISSION TO SHARE WITH CREST MANOR LIVING & REHABILITATION CENTER, INC., INFORMATION CONCERNING MY PERFORMANCE AS A PRESENT/FORMER EMPLOYEE.

THANK YOU FOR YOUR COOPERATION IN THIS MATTER.

2) TO EMPLOYER/FORMER EMPLOYER:

DUE TO THE PRIVACY ACT, MOST EMPLOYERS ARE NO LONGER COMPLETING REFERENCE REQUESTS WITHOUT THE EXPLICIT PERMISSION OF THE INDIVIDUAL INVOLVED. THEREFORE, I AM GRANTING YOU PERMISSION TO SHARE WITH CREST MANOR LIVING & REHABILITATION CENTER, INC., INFORMATION CONCERNING MY PERFORMANCE AS A PRESENT/FORMER EMPLOYEE.

THANK YOU FOR YOUR COOPERATION IN THIS MATTER.

3) TO EMPLOYER/FORMER EMPLOYER:

DUE TO THE PRIVACY ACT, MOST EMPLOYERS ARE NO LONGER COMPLETING REFERENCE REQUESTS WITHOUT THE EXPLICIT PERMISSION OF THE INDIVIDUAL INVOLVED. THEREFORE, I AM GRANTING YOU PERMISSION TO SHARE WITH CREST MANOR LIVING & REHABILITATION CENTER, INC., INFORMATION CONCERNING MY PERFORMANCE AS A PRESENT/FORMER EMPLOYEE.

THANK YOU FOR YOUR COOPERATION IN THIS MATTER.