Madisonhealth is an equal opportunity employer.

Qualified applicants are considered for employment, and employees are treated during employment without regard to race, color, religion, national origin, citizenship, age, sex, marital status, ancestry, physical or mental disability, veteran status, or sexual orientation.

Solely to help us comply with federal and state Equal Employment Opportunity record keeping, reporting, and other legal requirements, we request that you complete this data information questionnaire.

Refusal to complete this information will not subject any applicant or employee to adverse treatment. The information that you provide will be recorded and maintained in a confidential file, separate from all other records. This information will not be used in consideration for your employment.

Race/Ethnic Identification

  • White (Not of Hispanic origin): all persons having origins in any of the original peoples of Europe, North Africa, or the Middle East.
  • Black (Not of Hispanic origin): all persons having origins in any of the Black racial groups of Africa.
  • Hispanic: all persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.
  • Asian or Pacific Islander: all persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This area includes, for example, China, India, Japan, Korea, the Philippine Islands, and Samoa.
  • American Indian or Alaskan Native: all persons having origins in any of the original peoples of North America and who maintain cultural identification through tribal affiliation or community recognition.

Veteran Status

  • Special Disabled Veteran: (A) a veteran who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Department of Veterans’ Affairs for a disability (i) rated at 30 percent or more, or (ii) rated at 10 or 20 percent in the case of a veteran who has been determined under Section 3106 of Title 38, U.S.C. to have a serious employment handicap or (B) a person who was discharged or released from active duty because of a service-connected disability.
  • Vietnam Era Veteran: a person who (A) served on active duty for a period of more than 180 days, and was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty occurred: (i) in the Republic of Vietnam between February 28, 1961 and May 7, 1975; or (ii) between August 5, 1964 and May 7, 1975, in all other cases; or (B) was discharged or released from active duty for a service-connected disability if any part of such active duty was performed (i) in the Republic of Vietnam between February 28, 1961 and May 7, 1975; or (ii) between August 5, 1964 and May 7, 1975 in all other cases.
  • Other Veteran: veterans who served on active duty during a war or in a campaign or expedition for which a campaign badge has been authorized.

Persons with disabilities
An individual with a disability is any person who has a physical or mental impairment, which substantially limits one or more of such person’s major life activities.