If you are experiencing symptoms of COVID-19 or have been in close contact with someone who has COVID-19, please call the CVMS provider’s office prior to your scheduled appointment. If it is a life-threatening emergency, call 911.
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319-235-5390 1-800-211-9244
4150 Kimball Ave.
P.O. Box 2758 Waterloo, IA 50704
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Step 1 of 6

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    • Personal Information

    • Position Information

    • Date Format: MM slash DD slash YYYY
    • Will you work the following if required?

    • Date Format: MM slash DD slash YYYY
    • Date Format: MM slash DD slash YYYY
    • Date Format: MM slash DD slash YYYY
    • Date Format: MM slash DD slash YYYY
    • Date Format: MM slash DD slash YYYY
    • Date Format: MM slash DD slash YYYY
    • Education

    • High School or GED

    • (MM/YY-MM/YY)
    • (and Minor, if applicable)
    • College/University

    • (MM/YY-MM/YY)
    • (and Minor, if applicable)
    • (MM/YY-MM/YY)
    • (and Minor, if applicable)
    • Employment History

      (include Volunteer, Intern and Military)
    • Date Format: MM slash DD slash YYYY
    • Date Format: MM slash DD slash YYYY

    • Date Format: MM slash DD slash YYYY
    • Date Format: MM slash DD slash YYYY

    • Date Format: MM slash DD slash YYYY
    • Date Format: MM slash DD slash YYYY
    • Business References

      List four (4) professional references-(i.e. supervisor, instructor, co-workers)




    • Acknowledgment and Release

    • 1. I certify that the facts contained in this application (and accompanying documentation, if any) are true and complete to the best of my
      knowledge. I understand that any false statement, omission or misrepresentation on this application is sufficient cause for refusal to
      hire, or dismissal if I have been employed, no matter when discovered by Cedar Valley Medical Specialists, PC (CVMS).

      2. I understand and agree that nothing contained in this application or conveyed during any interview is intended to create an
      employment contract. I further understand and agree that if I am hired, my employment is without fixed term and at the option of
      either myself or CVMS and that my employment will be “at will” and may be terminated at any time by CVMS for any legal reason
      with or without cause and without prior notice.

      3. I authorize the investigation of any or all statements contained in this application including background checks, OIG query and/or
      motor vehicle driving records by CVMS. I also authorize, whether listed or not, any persons, companies, organizations and/or
      education institutions to provide relevant information and opinions that may be useful in making a hiring decision. I hereby release
      such persons and organizations from any and all liability in making such statements and CVMS and its officers, employees and agents
      from any and all liability from damage which may result from obtaining, reviewing or considering such information.

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Questions

Please call the providers office to schedule appointments or for any questions you may have. Waterloo, Iowa 4150 Kimball Ave. P.O. Box 2758 Waterloo, IA 50704 General Information: 319-235-5390 Billing: 319-235-5397 Medical Records: 319-235-5390 Call directly: (319) 235-5390
Patient Portal Pay Your Bill
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  • Home
  • About
  • Specialties
  • Providers
  • Medical Surgical Conditions
  • Careers
    • Employment Opportunities
    • Provider Opportunities
  • Contact

Administration Office:

4150 Kimball Ave. P.O. Box 2758
Waterloo, IA 50704
(319) 235-5390

Billing & Payment Questions:

(319)-235-5397
1-800-211-9244
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