Incoming House Officers

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)

The packet consists of the following forms:

• Agreement of Appointment (GME A)
• TB Form (GME-B)
• Driver Safety Form (GME-C)
• House Officer Moonlighting Form (GME-D)
• Health Requirements Form (GME-E)