HR Job Coach Document

HR JOB COACH DOCUMENT

Personal Information

Position & Availability

Desired Job Title:   Department:

Anticipated Start Date:   Employment Status: Full-time Part-time Contract/Temporary

Employment History (Most Recent 1)

Employment History (Previous 2)

Education

Professional References (3)

Initial Assessment & Coaching Plan

Session Frequency:   Preferred Session Times:

Legal Disclosures, Consent & Authorizations

At-Will Employment Statement: I understand that any employment relationship with a hiring entity remains at-will, unless otherwise expressly agreed in a separate, written employment agreement executed by authorized representatives. Nothing in this document creates a promise or guarantee of employment or continued employment.

Equal Opportunity Statement: The organization providing coaching services affirms equal opportunity in its programs and employment decisions without discrimination on the basis of race, color, religion, sex, national origin, age, disability, or any protected characteristic under applicable law.

Confidentiality and Limits: Coaching sessions are confidential to the extent permitted by law. Confidential information will not be disclosed except where disclosure is required by law or where there is a reasonable belief of imminent risk of harm to self or others, or where required to investigate alleged professional misconduct.

Authorization to Verify and Contact: By checking the box below, I authorize the job coach and authorized representatives to contact the references, prior employers, educational institutions, and other third parties I have listed for the purpose of verifying information contained herein and assessing qualifications. I also authorize background checks as required by the hiring process.

I authorize verification of my employment, education, references, and authorize background checks as required.

Data Use and Retention: I understand that personal information provided will be used for coaching and placement purposes, stored securely, and retained only as necessary to fulfill program obligations and legal requirements. I acknowledge that the organization may maintain records of coaching sessions, progress notes, and related documentation.

Release and Liability: I acknowledge that coaching is a collaborative process and that no specific employment outcome is guaranteed. I release the coach and the organization from liability for decisions I make or actions taken as a result of coaching, except where prohibited by law.

Applicant Certification & Acknowledgment

I certify under penalty of perjury that the information provided in this document is true, accurate, and complete to the best of my knowledge. I acknowledge that willful falsification of information may result in disqualification from coaching services or termination from employment consideration.

I consent to participate in the coaching program and to the terms set forth above. I understand my rights and responsibilities as a participant and acknowledge receipt of a copy of this form upon request.

I certify that the statements above are true and I consent to the terms and authorizations.

Administrative Use (For HR/Coach)

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