COUNTY OF LOS ANGELES
DEPARTMENT OF HEALTH SERVICES
RECRUITMENT & EXAMINATIONS OFFICE
To whom it may concern,
Below is the general information requested and required attachments for consideration of my application.
First Name:
Last Name:
Email:
Address:
City:
State:
Zip:
Work Phone:
Cell Phone:
Home Phone:
Date of Birth:
Social Security #:
Are you currently a County of Los Angeles employee?
If you are an active Department of Health Services employee you do not need to submit attachments as we will utilize previously submitted documents.
If you are a current employee, please enter your employee #:
Are you a Veteran?
If "Yes", please attach a copy of your DD214, Certificate of Discharge or Separation from Active Duty, or other official documents issued by the branch of service
Attach the following required documents
  • Curriculum Vitae
  • Statement of Career Goals
  • Legible copy of certificate of completion of residency training program approved by the American Specialty Board
  • Legible copy of California State Physician and Surgeon's Certificate authorized by the Board of Medical Examiners of the State of California
  • (If applicable) Copy of your DD214 Certificate of Discharge or Separation from Active Duty, or other official documents issued by the branch of service
Any missing information from the above list will be considered an incomplete application and may be rejected. Additionally, an application may be rejected if information is submitted by someone other than applicant.
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By submitting my information, I certify that all information and statements made in this application and any attachments pertaining thereto are true and complete to the best of my knowledge. I understand and agree that any false information and/or statement(s) of a material facts or omissions may subject me to disqualification or dismissal.