| Form Name: | Healthcare Network Break Glass Form |
|---|---|
| Completed By: | House Officer |
| Used When: | Completed by incoming House Officers in programs that rotate to LSU Healthcare Network facilities. |
| Purpose: | Acknowledgement of the LSU Healthcare Network Break Glass Policy. |
| Direct Questions To: | Ashley Walker |
| Form Link: | Auto-populated via Newhire Documents BreakGlassForm.pdf |
Instructions for Completing Form
This form is completed automatically as part of the online Newhire Documents process. It is included in the Newhire Packet that is submitted to the GME Office.
Other Info
See LSU Healthcare Network Break Glass Policy
Places This Form is Referenced
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Healthcare Network Break Glass Form (Forms & Documents)