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Onelife Exam is giving opportunity to medical examiner, phlebotomist or medical
personnel to tied up with our company to become an independent contractor,
whether, you have a direct or without a direct orders from a life insurance agent.
We are also opening the opportunity to every examiner, phlebotomist, medical
personnel and individual contractor to be a part of our nationwide expansion
program and be involve to become a part of our manpower outreach program, if,
you are qualified. And if, we create a good and beneficial relationship, we are in
search of a potential candidate for a managerial position to handle our branches
nationwide.
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Please read and check off the following for registration
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I understand, that upon completing this registration form, I am fully aware that I agree to respect and abide
by the conditions of Onelife Exam and all Federal, State and local laws pertaining to the confidentiality of
identifiable medical, personal and any confidential information obtained from their website.
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I understand, that by signing-up on the registration form, all information entered herein will be used for
screening and background check concerning work related issues or previous employment.
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I understand, that all medical or any health information I will acquire from life insurance applicant is
confidential and I have no authority to disclosed this information to anyone, except with Onelife Exam, in
order to process client's paramedical examinations and laboratory test. Note: This only applies to a
phlebotomist or a medical examiner employee of Onelife Exam.
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Does not apply to me, I'm not an employee of Onelife Exam
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I also understand, that by signing -up on this registration form, does not empower me to act or represent
Onelife Exam to negotiate, make any transaction or agreement in behalf of the company.
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I understand, that upon registration and submitting my information, Onelife Exam has the right to verify and
check the information I have provided, they also have the right to approved and disapprove my application
to obtain a Login ID or password to access their website and secured site. I also understand that upon
typing my name on the space provided for my electronic signature, this will serve as the equivalent of my
legal signature. By clicking the submit button, I will be accountable for all representations made at Log In
and for all work done under my Log In ID.
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I understand, that this is not a contract or a binding agreement, but solely, for registration
purposes only. By completing the registration process, I'm aware that it does not guarantee me
of any job or neither obligates Onelife Exam to offer me an employment or contract. My intention
and interest for a possibility of working with Onelife Exam is under their discretion and approval,
if, I would qualify and meet their requirements to become a medical examiner/phlebotomist. I also
understand, that, my account will be renewable every year and may be subjected for cancellation
by the discretion of Onelife Exam. And by checking the box, I agree with this terms and
conditions.
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Examiner Information
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Examiner Name
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Address
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Apt/Ste
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City/ State
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Zip Code
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Fax Number
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Cell phone
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Birth Date/mm/day/yr
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SSN
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Driver's License
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State Issued
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Expiration
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City
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Zipcode
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Name of School Last Attended
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Address
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State
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Degree/Certificate
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Dates Attended
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Date Completed
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License
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Specialty/ Training
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Highest Degree of Education
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Other Language Spoken
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Nationality
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Yrs Completed
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Language Spoken
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Age
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Sex
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Employer
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Address
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State
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Zip Code
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City
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Email Address
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Password Confirmation
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Security Question
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Work Phone
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Ext. No.
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Password
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Examiner's Electronic Signature
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Date Signed/Registered
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If you are interested in joining our team and become an employee of Onelife Exam, you can submit your
application online. Click the link below.
APPLY ONLINE
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