Per 2
Form Name: | Per 2 |
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Completed By: | Program Coordinator |
Used When: | Hiring House Officers |
Purpose: | This form routed to Human Resources to appoint the New Hire to the House Officer Position/Title |
Direct Questions To: | Yolanda Lundsgaard / Human Resources |
Form Link: | Online GME Appointment Forms |
Per 2 School Code Listing
The full list of schools availalbe in the PER 2 can be viewed at PER 2 School Code List. It may be easier to search in this list to assist locating the necessary code in the drop down menu.
Instructions for Completing Form
Download the pre-populated form found at the Online GME Appointment Forms link above, and fill in any missing information (highlighted in red). Submit to the GME Office with the Newhire Packet.
- Fillable PER 2 is also found on the HR website
- The PER 2 in the Online GME Appointment Forms Link Auto-Populates with House Officer Data from New Innovations. This is the PER 2 to submit with the New Hire paperwork
- The most recent revised PER 2 must be submitted, the date is found in the top right hand corner (R.12/17).
- The "Original" page of the PER 2 is the only page to print and attach to the New Hire Packet. Original is one of the tabs at the bottom of the form.
- Coordinators complete sections that are NOT auto-populated with data.
- Coordinators review the data entered on the PER 2.
- The House Officer’s name that appears on I-9 documents MUST be the name on the PER 2
- Coordinator attaches the PER 2 to the New Hire packet in the order listed on the Check list.
- These sections must be completed and correct on the PER 2 before submitting the PER 2 with the New Hire packet: fields not listed below are to be left blank
- #1 Effective Date – July 1, of the new Academic year; or Start Date if Off-Cycle.
- #1 Last 4 digit SS# – Last 4 digits must be included. If they do not have one, put applied for or pending, and submit a copy of the Social Security Card ASAP to HR and GME when received
- #2 Name - The name that appears on the Per 2 must match the name on the social security card or the legal documentation copies submitted (used for I-9 form). Cannot use nicknames, married names or maiden names if it doesn’t match; Enter Last name and First name where requested on the form.
- # 3 Title –House Officer Level (HO 1-7 for residents; HO 8-10 for fellows)
- #5 School or Division - Medicine for Medical School; Dental for Dental School
- #5 Department – Must Include Program Name following Department Name. (e.g. Medicine-Cardiology, Medicine/Emergency Medicine, Pediatrics-Neonatology, Surgery-Vascular Surgery, etc.)
- #6 Work Location - Department Codes and Location Codes- PPS Dept. Code and Location Code are auto-populated correct code for program must be entered in this section. If you are not sure of the Location Code, it is the code used to run the Beginning of the Month and End-of-the Month reports. Include Department phone # in this section, and Department Parish
- #7 Educational level or College Degrees
- MUST include all degrees - Bachelors and above. THIS INCLUDES MEDICAL SCHOOL/DENTAL SCHOOL DEGREE, MASTERS and Ph.D.
- LSU/BR code is 002010 - La State U and A&M C; LSUHSC (Medical/Dental School) Code is 002014 - La St U Medical Center; DO NOT use Code 008745 for LSU. When reviewing, entering or selecting from drop down box for school codes, make sure they are the correct name and code for the school.
- DO NOT USE Medicine Discipline for Osteopathic Medicine Degree – Osteopathic Medicine Discipline has its own Discipline code, it is 181301 and should NOT be coded as MDs they are DOs.
- MUST include School names and CORRECT graduation Date and Discipline.
- # 8 Percent of Effort: is 100%;
- EMPL ID #8 – if the House Officer is a graduating LSU Senior and the EMPL ID is known, it will appear in this space, if not, enter it in this space, if the House Officer was previously a Medical Student at LSU or employed by LSU-N.O., Baton Rouge, Lafayette, Bogalusa, Lake Charles; use the EMPL ID issued at that time of student enrollment or employment.
- I-9 Doc Attached – Check the box - I-9 documents must be attached
- #10 Salary and Distribution – Base Rate of Pay: Hourly Rate approved for the Academic year and On the Basis of “Fiscal Yr” is auto populated.
- #10 Salary and Distribution – numbers are auto-populated in this section. the numbers are for the Resident Suspense Account . DO NOT USE ACCOUNTS ENTERED IN PS-RTS for Monthly Assignments ON PER 2s.
- Signed – Coordinator signs the PER 2, if he/she has signature authority, if not, then the Business Manager or Assistant Business Manager must sign the PER 2.
- Print the "Original" page of the PER 2 and attach the PER 2 to New Hire Packet and submit to GME Office
- #1 Effective Date – July 1, of the new Academic year; or Start Date if Off-Cycle.
Other Info
Insert any other pertinent info about form
Places This Form is Referenced
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PER 2 (Terms and Abbreviations)
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Personnel Appointment Form (Terms and Abbreviations)
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Newhire Packet (Forms & Documents) — 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)
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Per 2 (Forms & Documents)
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GME Online Appointment Forms (Policies and Procedures) —
Log in at https://www.medschool.lsuhsc.edu/medical_education/graduate/appointments/
If prompted, log in with your LSU username and password.
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Newhire Documents Tab (Policies and Procedures) — Includes the following forms and information:
- Per 2
- Newhire Checklist
- Online Newhire Packet Instructions and Login Information
LSU GME Knowledge Base
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