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Incoming House Officers

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Created by Chris Callac on Aug 30, 2016

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Newhire Packet submitted to GME Office

Appointment Packet

Newhire Packet

This packet consists of the following forms:

GME-1 - Newhire Checklist
GME-2 - GME Data Sheet

Human Resource Management New Hire Documents:

- PER 2 - Personnel Form - Paper Form auto-populates House Officer data from New Innovations; download from AY Forms, (signed by Business Manager or designee)
- HR-1 - Biographical Data Form (Must include College & Medical School & Graduation dates)
- HR-2* - Background Check clearance email (Must be dated prior to appointment /start date)
- HR-3* - Drug Screen clearance email notification (Must be dated prior to appointment/start date)
- HR-4 - Drug Screen: Drug Screening Instructions (must be signed by house officer)
- HR-5 - Drug Screen: Agreement to submit to Drug/Alcohol Testing Form (must be signed by house officer)
- HR-6A - Alien Tax Information Request (Only Non-US Citizens)
- HR-7A - Alien / Foreign National Identification Documents:
  - J-1Visa or Permanent Resident Card (Green Card)
  - DS 2019 (if on J-1 Visa)
  - Foreign Passport
  - I-94
- HR-8 - Oath of Affirmation
- HR-9 - W-4 Form
- HR-10 - L-4 Form
- HR-11 - Act 372 – Selective Service Registration
- HR-12 - Data Protection Form
- HR-13 - Direct Deposit with Voided Check
- HR-14 - Copy of Social Security Card (signed by employee; copy needed for HRM benefits)

Appointment Packet submitted to GME Office

Appointment Packet

Appointment Packet

The packet consists of the following forms:

Listed on Appointment Form

Listed on Malpractice Spreadsheet

Submit LSBME Letter

If FMG on J-1 Visa

Submit DS-2019

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