Equal Employment Opportunity Survey
Dymentum Health is an Equal Opportunity/Affirmative Action Employer. Our organization is firmly committed to the principles of equal employment opportunity and affirmative action. All employment-related decisions are made without regard to race, ancestry, color, religion, gender, age, marital status, medical condition, disability, national origin, veteran status or any other basis protected by law. The federal government requires that an employer maintain records on the sex, ethnic group and veteran status of its applicants. See Uniform Guidelines on Employee Selection Procedures, 29 C.F.R. 1607 et seq., 41 C.F.R. 60-3.1 et seq. (178). In order to comply with these requirements, we respectfully request that you supply the information requested to assist us in satisfying our obligations under federal, state and local employment laws. Your response to the Equal Employment Opportunity Survey is voluntary, but is greatly appreciated and in no way affects employment decisions. The information you provide is confidential and is maintained separately from any records related to your employment application. We thank you in advance for your cooperation.
Race/Ethnicity:
American Indian or Alaska Native (Not Hispanic or Latino)- A person having origins in any of the original peoples of North and South American (including Central America), and who maintains tribal affiliation or community attachment.
Black or African American (Not Hispanic or Latino)- A person having origins in any of the Black racial groups of Africa.
Hispanic or Latino- A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.
Asian (Not Hispanic or Latino)- A person having origins in any of the original peoples of the Far East, South Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
White or Caucasian (Not Hispanic or Latino)- A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)- A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
Two or More Races (Not Hispanic or Latino)- All persons who identify with more than one of the above five races.
Veteran Status: (Please check all that apply)