Emergency Veterinary Assistant - Woodbridge, VA

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 following categories:

• Disabled veteran
• Recently separated veteran
• Active duty wartime or campaign badge veteran
• Armed forces service medal veteran

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.

Equal Employment Opportunity Policy

We do not discriminate on the basis of any protected group status under any applicable law.

Protected Veterans

As set forth in Veterinary Emergency Group (VEG)'s Equal Employment Opportunity policy, we do not discriminate on the basis of any protected group status under any applicable law.

OMB Control Number

OMB Control Number 1250-0005
Expires 04/30/2026

Definition of Disability

To determine if you have a disability, consider whether you have or have ever had 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 kidney disease
• Chronic obstructive pulmonary disease (COPD)
• Diabetes
• Epilepsy
• Fibromyalgia
• Gastrointestinal disorders
• HIV/AIDS
• Lupus
• Migraine headaches
• Multiple sclerosis (MS)
• Narcolepsy
• Neurodevelopmental disorders
• Obstructive sleep apnea
• Parkinson’s disease
• Post-traumatic stress disorder (PTSD)
• Psoriasis
• Rheumatoid arthritis
• Schizophrenia
• Short stature (dwarfism)
• Spina bifida
• Stroke
• Tourette’s syndrome
• Ulcerative colitis
• Uveitis
• Visual impairment
• Wound healing

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.

Government Contractor Information

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.

Completing this form is voluntary, and we hope that you will choose to do so. 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. If you want to learn more 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.