Form Name:	Newhire Packet
Completed By:	Program Coordinator and Incoming House Officer
Used When:	Used to hire the incoming House Officer
Purpose:	This packet contains all needed documentation for the GME Office and Human Resources
Direct Questions To:	Yolanda Lundsgaard
Form Link:	See Below

Instructions for Completing Form

Instructions for Completing Forms

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)

Reflects updated forms for the 2024-2025 Academic Year

Sample New Hire Packet

This is a completely filled out New Hire Packet, and represents exactly how the packet should be submitted to the GME Office. While all of the content in the packet should be checked, the shaded areas call out specific sections of the forms that should be checked closely (signatures and other important pieces of data). Note: This packet is sized to fit on legal paper, which will print all of the forms full-size. However, it can be reduced comfortably onto letter size pages.

Download Sample Packet

Places This Form is Referenced

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House Officer OSHA Respirator Medical Evaluation Questionnaire (Forms & Documents)
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Sample New Hire Packet (New Hires)
Page:

PER 3 (Paper); ePAF for Terminations (electronic Personnel Action Form/PER 3); eCSOF for Change in Source of Funds (Forms & Documents)
Page:

Direct Deposit Form (Forms & Documents)
Page:

Data Protection Form (Forms & Documents)
Page:

Selective Service Registration Form (Forms & Documents)
Page:

L-4 (Forms & Documents)
Page:

W-4 (Forms & Documents)
Page:

Oath of Affirmation Form (Forms & Documents)
Page:

Alien Tax Form (Forms & Documents)
Page:

I-9 Form (Forms & Documents)
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Biographical Data Form (Forms & Documents)
Page:

Library Form (Forms & Documents)
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LSBME Release Form (Forms & Documents)
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Healthcare Network Break Glass Form (Forms & Documents)
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FCVS Release Form (Forms & Documents)
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GME Data Sheet (Forms & Documents)
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Newhire Checklist (Forms & Documents)
Page:
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)
Page:

Per 2 (Forms & Documents)

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