U N I V E R S I T Y   O F   I L L I N O I S

Conditional Hire Acknowledgment

To establish and maintain the safety for students, customers/clients, and patients/subjects utilizing University of Illinois facilities and hospital, and to comply with the Campus Security Act, the  Illinois Health Care Worker Criminal Background Check Act (HCWCBCA) and the Medicare-Medicaid Anti-Fraud and Abuse Amendments by conducting criminal/sanctions background checks on all UIC prospective employees who have the potential for contact with UIC patients or have been excluded from participation in Federal or State Health Care Programs. It is the intent of this policy to maintain continuity with the provisions of the Campus Security Act, HCWCBCA and the Medicare-Medicaid Anti-fraud and Abuse Amendments to reduce risk to students, customers/clients and patients/subjects in a manner consistent with other universities and Illinois Health Care providers.

Applicants that are considered for employment in positions identified as security sensitive, having the potential for direct patient contact or may perform work in positions requiring sanctions review as defined by the University of Illinois Board of Trustees on July 17, 2003, must undergo a criminal/sanction background check and meet all the requirements of the University policy.  A conditional offer of employment may be made pending the results of the criminal/sanction background check.

This is to acknowledge that I understand my employment status is conditional until my criminal/sanction background check is cleared.  If a disqualifying criminal conviction is discovered, I understand that my position at the University will be immediately terminated without any further employment rights including tenure and notice of non-reappointment rights.   I can challenge the accuracy or completeness of the report by requesting a fingerprint-based check for a criminal conviction

I also understand that if I appear on a federal, state or other mandated governmental exclusion listing, my position at the University will be immediately terminated, without any further employment rights including tenure and notice of non-reappointment rights.  I can challenge the accuracy and completeness of the report by contacting the appropriate federal or state agency.

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Name (Please Print)     

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UIN Number

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