Voluntary Self-Identification
For government reporting purposes, we ask candidates to respond to the self-identification survey below. Filling out the form is entirely voluntary . No matter what decision you make, it will not be considered during or after the hiring process. Any information you provide will be recorded and kept in confidential documents.
As stated in CareRev’s Equal Employment Opportunity Policy, we do not discriminate on the basis of any protected group status under any applicable law.
Please specify your Race
Definition of Race and Ethnicity
If you think you belong Any of the categories of protected veterans listed below, please indicate by making the appropriate selection. As a government contractor subject to the Vietnam-era Veterans Adjustment Assistance Act (VEVRAA), we request this information to measure our performance under VEVRAA Effectiveness of outreach and active recruiting efforts. The classification of protected categories is as follows:
A “Veteran with Disabilities” is one of the following: Veterans who served in the United States Armed Forces, Army, Navy, or Air Force and are entitled to Compensation under laws administered by the Secretary of Military Affairs (or will be entitled to compensation if military retirement pay is not received); or those who have been dismissed or discharged from active duty due to a service-related disability.
“Recently Serviced Veteran” means any veteran within a three-year period from the date of discharge or discharge who has served in the U.S. Army, Ground, Navy or Air Force service.
“Active Duty Wartime or Campaign Badge Veterans” means active duty veterans who served in the U.S. Army, Ground, Navy, or Air Force during the war, or as regulated by the Department of Defense , a campaign or expedition that has been authorized by a campaign badge.
“Armed Forces Service Medal Veteran” means a member of the Armed Forces Service Medal awarded by the United States under Executive Order 12985 while serving in the U.S. military, ground, navy, or air force military operations.
Form CC-305
OMB Control No. 1250-0005
Expires 05/31/2023
We are a federal contractor or subcontractor required by law to serve qualified persons with disabilities Provide equal employment opportunity. We also need to measure our progress towards having at least 7% of our workforce be disabled. To do this, we must ask applicants and employees whether they have or have had a disability. Because a person can become disabled at any time, we require all employees to update their information at least every five years.
Identifying yourself as a disabled person is voluntary and we hope you will choose to do so. Your responses will be kept confidential and will not be seen by the selection officer or anyone else involved in personnel decisions. Filling out the form will not negatively affect you in any way, whether or not you have self-identification in the past. For more information on this form or federal contractors’ equal employment obligations under Section 503 of the Rehabilitation Act, please visit the US Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.
How do you know if you have a disability?
If you have a physical or mental disability or medical condition that severely limits major life activities, then You are considered disabled, or if you have a history or record of such an impairment or medical condition.
Disabilities include but are not limited to:
Autism
Autoimmune diseases such as lupus, fibromyalgia , rheumatoid arthritis, or HIV/AIDS
Blind or low vision
cancer
Cardiovascular or Cardiac Disease
Celiac disease
Cerebral Palsy Deaf or hard of hearing
Depression or anxiety
diabetes
Epilepsy
Gastrointestinal disorders, eg, C Roan’s disease or irritable bowel syndrome
Intellectual disability
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Missing or partially missing limbs
- Nervous system diseases such as migraine, Parkinson’s disease, or multiple sclerosis (MS)
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- mental illness such as bipolar disorder, schizophrenia, post-traumatic stress disorder or major depressive disorder
Disabled status
1
Section 503 of the Rehabilitation Act 1973, as amended. For more information on this form or the equal employment obligations for federal contractors, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.
Public Charge Statement: Under the Paperwork Reduction Act of 1995, no one is required to respond to a collection of information unless such collection shows a valid OMB Control Number. It takes approximately 5 minutes to complete this survey.
Cardiovascular or Cardiac Disease
Cerebral Palsy Deaf or hard of hearing
- Intellectual disability
-
- Missing or partially missing limbs
- Nervous system diseases such as migraine, Parkinson’s disease, or multiple sclerosis (MS)
- mental illness such as bipolar disorder, schizophrenia, post-traumatic stress disorder or major depressive disorder
Disabled status
1
Section 503 of the Rehabilitation Act 1973, as amended. For more information on this form or the equal employment obligations for federal contractors, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.Public Charge Statement: Under the Paperwork Reduction Act of 1995, no one is required to respond to a collection of information unless such collection shows a valid OMB Control Number. It takes approximately 5 minutes to complete this survey.
