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                                                                                                                        CONSENT AGREEMENT

I hereby certify that the answers to the following questions are true to the best of my knowledge and agree to have any of the statements checked by Conifer Health Solutions unless I have indicated to the contrary.

I understand that employment is contingent upon satisfactory completion of reference, employment, credit, and/or education checks.

Should a job offer be made to me, I consent to taking a pre-placement physical examination and such future examinations as may be required by Conifer Health Solutions. I understand that any job offer or my continuing employment, if hired, is contingent upon my being physically, mentally and medically able, with or without reasonable accommodation, to successfully perform the essential functions of my job. I agree that the results of my medical/health screen may be released to appropriate agencies in the event of a worker's compensation injury and/or dispute on payment of a medical claim. I understand that as part of my pre-placement physical examination, upon which any offer of employment is contingent, I will be required to successfully pass a drug screening test. The test will be administered at Conifer Health Solution's expense, and will require me to provide a urine specimen for analysis. The urine specimen will be analyzed for the presence of any type of drugs. Results of the drug test are confidential, and will not be disclosed to others without my specific written consent. My electronic signature below specifically signifies my consent to this pre-placement drug screening test.

I agree to wear or use all protective clothing or devices that may be required for the performance of my job duties and to comply with all safety policies and procedures.

I understand that nothing contained in this employment application is intended to lead to or create an employment contract between Conifer Health Solutions or any subsidiary or affiliate and myself which would in any way restrict the right of the company to terminate my employment at will.

I further understand and agree that the employment relationship that may result from my application will be employment-at-will, and either I or Conifer Health Solutions or any subsidiary or affiliate may terminate the relationship at any time.

I understand that any omission, misrepresentation or falsification can be grounds for refusal of employment. I further understand that, if employed, any false statements or misrepresentations herein or in conjunction with the application process may be cause for dismissal.

I understand that any and all disputes regarding my employment with Conifer Health Solutions, including any disputes relating to the termination of my employment, are subject to the Conifer Health Solution Fair Treatment Process, which includes final and binding arbitration, and I also understand and agree, as a condition of employment and continued employment, to submit any such disputes for resolution under that process, and I further agree to abide by and accept the decision of the Arbitration panel as the final and binding decision and resolution of any such disputes I may have.