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A paper PER 3 is required to Promote House Officers.  The Paper PER 3 is found on the LSUHSC website:  Human Resources Forms - House Officer PER 3 (Scroll down on left side find PER 3 (Student Workers, House Officers, POA supplements), Click on the Link, the PER  3 form in Excel format will open.

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Per 3 Header
Per 3 Header

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PER 3 Department Code
PER 3 Department Code

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PER 3 Promotion Section
PER 3 Promotion Section

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PER 3 Other Remarks Section
PER 3 Other Remarks Section

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#13 Salary and Distribution


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  • Effective – Enter the Beginning date of the Academic Year or the Beginning date of the House Officer’s period of Appointment if it does not Begin July 1.     
  • Funds End Date – Enter the Ending date of the Academic Year or the Ending date of the House Officer’s period of Appointment, if it does not end June 30.
  • Rate of Pay
    • from $ - If promoting or level is changing, Enter the current Hourly pay rate (available on the House Officer Pay Scale)
      • Enter an “X” in the Hourly box.  If not promoting or level is not changing, leave blank.
    • to $ - Enter the new hourly pay rate if promoting (available on the House Officer Pay Scale); Enter the Current pay rate if there is no change to the hourly pay rate.
      • Enter an “X” in the “Hourly” box.
  • On the basis of
    • Period of Appt - Enter an “X” in the “From” and “To” boxes


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PER 3 Chart Section
PER 3 Chart Section

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PER 3 Signature Section
PER 3 Signature Section

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PER 3 Routing Instructions
PER 3 Routing Instructions

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titleSample PER 3s

Off-Cycle Promotion