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LSBME Release Form

LSBME Release Form

Owned by Chris Callac
Last updated: Nov 18, 2022 by Sara Blakemore
Form Name:LSBME Release Form
Completed By:House Officer
Used When:Completed by all incoming House Officers
Purpose:

Allows LSU to report to LSBME if House Officer withdraws or is terminated from the program.

Direct Questions To:

Sara Blakemore

Form Link:

Autopopulated for newhires: Newhire Documents

LSBME Release Form.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. It is also completed and submitted to the GME office when a House Officer is transferring between programs.

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