Emergency Veterinary Assistant (Relief) - Franklin, TN

Why are you being asked to complete this form?

We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualified people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says we must measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disability or have ever had one. People can become disabled, so we need to ask this question at least every five years.

Self-Identification Survey

Please indicate if you belong to any of the categories of protected veterans listed below: Disabled veteran Recently separated veteran Active duty wartime or campaign badge veteran Armed forces service medal veteran

Equal Employment Opportunity

Veterinary Emergency Group (VEG) does not discriminate on the basis of any protected group status under any applicable law.

Government Reporting

As part of government reporting requirements, we ask candidates to complete this self-identification survey. Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiring process or thereafter. Any information that you do provide will be recorded and maintained in a confidential file.

Disability Information

To determine our progress towards our goal of having at least 7% of our workers as people with disabilities, we must ask applicants and employees if they have a disability or have ever had one. A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever had such a condition, you are a person with a disability. Disabilities include, but are not limited to:

• Asthma
• Bipolar disorder
• Celiac disease
• Cerebral palsy
• Chronic fatigue syndrome
• Diabetes
• Epilepsy or other seizure disorder
• Fibromyalgia
• HIV/AIDS
• Lupus
• Migraine headaches
• Multiple sclerosis (MS)
• Narcolepsy
• Neurodevelopmental disorders, including ADHD, autism spectrum disorder, dyslexia, dyspraxia, and other learning disabilities
• Parkinson’s disease
• Post-traumatic stress disorder (PTSD)
• Short stature (dwarfism)
• Sickle cell disease
• Spina bifida
• Systemic lupus erythematosus (SLE)
• Tourette syndrome
• Ulcerative colitis
• Uveitis
• Werdnig-Hoffmann disease
• Other autoimmune disorders
• Other chronic conditions

If you believe you belong to any of these categories, please indicate by checking the appropriate box. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way.

For more information about the law or this form, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.