PLEASE REVIEW THE STATEMENTS BELOW AND SIGN
I authorize the ABHRS (sometimes referred to as “Board”) to make whatever inquiries and investigation it deems necessary to ascertain and verify my qualification, credentials, and professional standing through the Federation of State Medical Boards or other similar primary source verification agencies and further to inquire into my moral or ethical character from other resources as necessary in order to judge my application. I acknowledge that the processing and consideration of my application will involve participation by numerous members of the Board and staff on behalf of the Board and agree that these activities shall not be considered to be a disclosure, production, inspection, nor dissemination by the people performing these tasks. I will not commence, bring or institute a proceeding, suit, or action in any court or other tribunal or forum directed against or to the Board or any of its members or staff in any way concerning, pertaining to, or arising out of the consideration, proceeding, rejection, deferment, acceptance, or other handling of this application for membership in the Board or any of the inquiries or investigations conducted in connection therewith provided said processing is done in a proper and ethical manner.