Miles Vandenbrant

St. Christina's Psychiatric Rehabilitation Center & St. Christina's Medical Center.

Please use blue or black ink when filling out this application for employment. Please answer all questions to the best of your ability. For further information or guidance, please contact a member of St. Christina staff at the number provided in our guide brochure.

Full Name: VANDENBRANT, MILES

Age: 36
DOB: 10/31/1974
Gender: Male
Address: 2723 Cruickshank Rd
City: Phoenicia
State: NY
Ethnicity: Caucasian
Height: 6’1”
Weight: 155lbs.
Eye Color: Brown
Hair Color: Brown
Distinguishing Marks: N/A


Medical History:

Be advised that answers to this section will not have bearing on your eligibility for employment at the St. Christina Facilities. The information you provide will not be diverged to third parties.

Please list any and all allergies and age of onset below:
I have mild seasonal allergies to pollen but they're controlled on drug store medication. I've had them as far back as I can remember.

Are you aware of any ongoing medical issues?:
I am not aware of any ongoing medical issues.

If yes, list age of diagnoses by medical professionals, or age of onset below:
N/A

If you are receiving treatment for an ongoing medical complaint, please list prescriptions, strength of dose, frequency of dose, and other treatment plans below:
N/A

Do you smoke tobacco, consume alcohol, or use street drugs? If yes, please list number of packs per day, number of drinks per day and/or names of consumed drugs below:
I do not smoke or use street drugs but I do drink from time to time. Just a few while out with friends. Nothing serious.



Employment Interview:

To which location are you applying for employment? Please choose: St. Christina Psychiatric Rehabilitation Center/St. Christina Medical Center:
St. Christina Psychiatric Rehabilitation Center

For which position(s) are you applying within the St. Christina Facilities? Please also list the facility to which you are applying:
I’m applying for the attending physician at St. Christina’s Psychiatric Rehabilitation Center

Why do you feel that you would be the best choice for this position?:
My career in medicine has mainly been made up of treating those with mental health issues or drug abuse problems. I feel that I would be the best for this position because of this experience.

Do you possess necessary qualifications for the position(s) for which you are applying? If yes, please list official qualifications below:
I have my PhD in medicine.

Have you ever worked in a psychiatric or medical facility before? If yes, please provide facility name and dates of employment below:
After I finished medical school I went to work for my father’s medical practice for a short time. However, I did not find it as rewarding as I had hoped. I then went to work for A Place for Hope Rehabilitation Center and was there for a number of years before I came to the Hadley Institute.

Are you aware of any mental, physical or emotional impediments whatsoever that you feel may interfere with your ability to perform in the position(s) for which you are applying? These may include, but are not limited to substance addictions, medical issues, moral complications or difficulties working under pressure or strict guidance. If yes, please explain below:
I am not aware of any issues.



Qualification History:

What is the highest level of education you have completed? Please list year of graduation and all courses completed below:
I have my PhD in medicine.

Please provide the name(s) of schools from which you have graduated below:
I attended Boston University for my undergraduate as well as medical school. I did my residency at Beth Israel Deaconess Medical Center.

Do you possess any other skills that you feel may benefit your ability to perform in the position(s) for which you are applying? Examples include extra languages, history of customer service and work in the care industries, etc. If yes, please list skills below:
If being an accomplished juggler counts then I say yes. One cannot take the job so seriously all the time and I feel that my light hearted approach puts patients at ease sometimes.

Please list all previous employment below, including locations and approximate dates of employment:
Vandenbrant Family Practice (2003-2004)
A Place for Hope Rehabilitation Center (2004-2010)
Hadley Institute for Troubled Youth (2010-2011)

How do you feel your previous employment will benefit your ability to perform in the position(s) for which you are applying?:
Working at Hadley allowed me to work with patients with a lot more serious issues than I had at A Place for Hope. I believe that my experience at both of these facilities will benefit me in working with the patients at St. Christina’s.



Legal History:

Be advised that answers to this section will not have bearing on your eligibility for employment at the St. Christina Facilities. The information you provide will not be diverged to third parties.

Do/did you ever abuse controlled substances, including but not limited to prescription medications, street drugs or alcohol? If yes, please explain below:
As a teen I abused marijuana heavily but quit before I graduated high school. I have no touched the stuff since.

Have you ever been convicted of a crime? If yes, please list conviction, age of conviction and circumstances below:
My juvenile record has my drugs conviction in it but that is sealed. I was sixteen at the time.

If you answered yes to the above, please list sentences connected to these convictions below:
As it was my first offence I was sent to court ordered rehab and had to do community service.

Have you ever knowingly committed a crime for which you were not convicted or sentenced? If yes, please explain below:
I smoked marijuana a number of times, more than they found out about.



Personal Interview:

Describe yourself to the best of your ability in only five words:
Friendly, goofy, light-hearted, outgoing.

Describe how you would handle a situation in which a patient may become violent towards themselves or others:
If they’ve become violent then they’d need to be restrained. Once the situation is under control I’d have the patient removed so that they can calm down.

If your immediate supervisor instructed you to complete a task to which you felt morally opposed, how would you handle the situation?:
I would explain to my employer that I am not comfortable with the task and that they ask someone else to do it.

If you discovered a fellow employee breaking facility rules and endangering patients or staff, how would you handle the situation?:
Depending on the situation, I would either confront the individual or take it straight to management. Something small I’d try to talk to them myself but if it were something serious I would do my best to stay out of it.

If hired, would you agree to sign a binding non-disclosure agreement, knowing fully that you would hence forth be unable to discuss any procedures, methods, patient information or staff information with anyone outside of the St. Christina Facilities and their staff?:
Yes.

If hired, would you agree to follow any and all instructions given to you by facility supervisory staff and administrative staff without question, and knowing that you would be unable to discuss decisions with outside parties?:
Yes.


Green Ridge Residential Registration:

Please list your chosen address within Green Ridge:
15 Sunset Boulevard

Please list any dependents under the age of thirteen, who reside with you:
N/A

Please list your marital status. Single/Married/Divorced/Widowed:
Single

If married, please provide the name of your spouse if he/she resides with you:
N/A



Employee Signature:

By applying for and accepting employment within any of our facilities, you hereby agree to abide by all rules and terms of service outlined in employee handbooks, rules and codes of conduct. You hereby agree to undergo a background check and/or drug test should GR Biotech feel it pertinent prior to accepting your application for employment. You hereby agree to undergo any further, random drug testing should it be necessary. You hereby agree to communicate and work in accordance with fellow facility staff in regards to the recommendations, demands, or outlines for treatment of the patients in the facility, and to comply with your immediate supervisor should she/he suggest differently. You hereby agree to waive your right to hold GR Biotech and its Subsidiaries responsible for any personal harm or distress incurred during or after employment. You hereby waive your right to communicate with any non-St. Christina Facility staff regarding any facility methods or procedures or patient information or treatments. GR Biotech and its Subsidiaries reserve the right to add or amend these terms of service at any time.

By opting to relocate to Green Ridge Island and the town of Green Ridge, you hereby agree to abide by all Green Ridge Island laws and the instructions of Green Ridge Security, Green Ridge Town Officials, and St. Christina Facility administrators. You hereby waive rights granted to you by the state of Oregon or any other state belonging to the United States of America or to any other country or county. You acknowledge that Green Ridge Island, the town of Green Ridge and the St. Christina facilities are not subject to any state laws. You acknowledge that any personal property transported to Green Ridge Island becomes the responsibility of GR Biotech and its subsidiaries. You hereby waive your right to register to vote in any states within the continental United States, within the states of Alaska and Hawaii, and within any US territories. You waive your right to representation by any political parties or persons within the aforementioned US locations or other countries. You acknowledge that you are legally bound not to disclose information regarding Green Ridge laws, protocols or procedures of any kind with persons not residing on Green Ridge Island. You acknowledge that visitors to Green Ridge Island become the sole responsibility of the undersigned, and are subject to the same laws, protocols and procedures as Green Ridge island residents during their stay. You acknowledge that visitors to Green Ridge Island are subject to surveillance by Green Ridge officials and employees, and may be removed from the island without notice. You acknowledge that any minors under the age of thirteen (13) that are claimed as dependents remain the sole responsibility of the undersigned, and are subject to the same laws, protocols and procedures as all Green Ridge Island residents. GR Biotech and its Subsidiaries reserve the right to add to or amend these terms of service at any time.

Please sign and date below:

Miles Vandenbrant 05/30/2011

edited! derp :]

Thankyou for taking interesting in joining our dedicated team of St. Christina's staff. Below, you'll find your employment and residential details. Whether you applied to our Medical Center or our Psychiatric Rehabilitation Center, we ask that you take this time to familiarise yourself with pertinent handbooks, rules and regulations, and we welcome you to green Ridge and to the St. Christina's team.

Job Title: Attending Physician
Location: St. Christina Psychiatric Rehabilitation Center
Residential Address: 15 Sunset Boulevard


Final Application Approval Steps for Players:


Before you can begin play on STC, you must complete these final steps:

• Sign up your playby on the faceclaim.
  
• Sign up for the who plays who list.
  
• Sign up for your assigned membergroup (shown above) HERE (Pay close attention to pick the correct usergroup listed on this approval stamp! Characters that are not signed up for their correct membergroups after approval will be subject to deletion during the next activity check.)
  
• Familiarise Yourself with your Staff & Resident Handbooks, located in the St. Christina's Rosters and Information, and Green Ridge Rosters & Information forums, on the main board.

Code:

[center][font=garamond][size=22][color=#555555][b] -File Note- [/b][/color][/size][/font]

_____________________________________________________________[/center]

[b]Employee Name:[/b] Vandenbrant, Miles
[b]Job Title:[/b] Attending Physician
[b]Location:[/b] St. Christina Psychiatric Rehabilitation Center
[b]Residential Address:[/b] 15 Sunset Boulevard

[center]_____________________________________________________________[/center]

[b]Note Subject:[/b] (Behavioural Report, Progress Report, Procedure Report, Disciplinary Report, etc.)

[b]Note Contents:[/b] (Explain behaviour observations, procedures, disciplinary actions, medical reports, etc. here)

[b]Note Author:[/b] (Your character name here.)

[b]Other:[/b] (Optional extra notes here.)