Consent & Terms for Collection of Personal Information

By completing and submitting this form, you understand and agree to the following:

What we're collecting. This form requests your Social Security Number (SSN), date of birth, and home address.

Why we need it. This information is required solely to enroll you in payroll, verify your identity and employment eligibility, process tax withholding, and administer benefits as part of your onboarding with EPIC Veterinary Urgent Care.

Who sees it. Your information will be shared with our Professional Employer Organization (PEO), Insperity, and applicable federal and state tax and benefits authorities as required to process payroll and employment. It will not be sold, rented, or shared for marketing or any unrelated purpose.

How it's protected. Your information is transmitted and stored using encrypted, access-restricted systems. Access is limited to authorized personnel with a legitimate business need.

How long we keep it. Your information is retained only as long as required for payroll, tax, and recordkeeping obligations under applicable law, after which it is securely deleted or destroyed.

Your acknowledgment. You confirm that the information you provide is accurate and that you are submitting it voluntarily for the purpose of your employment onboarding. If you have questions about how your information is handled, contact [HR contact name / email].