Welcome packets for mailing to new hires:

Coordinators, please mail the appropriate forms below to your new hires along with postage paid return envelopes. Call the GME Office if you need information on ordering postage paid envelopes. Include 2 envelopes when mailing to interns so that they can mail back the Request for Special Consideration form separate from the other forms if necessary.

New Hire & Promotion Forms

Appointment Agreement (Contract)

New Hire/Promotion Paperwork Checklist -UPDATED FORM!

Code of Conduct -Compliance Awareness Training: Study Guide, Test

Data Sheet

HIPAA Exam, HIPAA Study Guide

License Requirement Agreement -UPDATED FORM!

List of All Housestaff Request Form 08-09

L-3A Form - unlicensed trainees only

Medical Records Agreement

Previous Training & Competency Verification Form

Primary Source Verification Form

Release of Information Form

Reorientation form for Housestaff -don't turn in to the GME Office

Resident Application (a.k.a.Green Sheet)

 

Employee Health Packet

 

Human Resources Packet

Agreement of Understanding

Background Information Policy

Direct Deposit Authorization

Emergency Contact

Employee Withholding Allowance Certificate (Form DE 4)

Employment Eligibility Verification (Form I-9)

Employment Information

Form W-4 Employee's Withholding Allowance Certificate

Important Information for Incoming Employee

Notification of LA County Pension Savings Plan

Outside Employment Policy Acknowledgment

Statement on Worker's Compensation Law Regarding Choice of Physician

Time Cards (2)

Warrant Recipient Designation

Year End Forms

Diploma Request Form 2008

Graduating/Exiting Housestaff List Request Form 2008

Other Forms

Los Angeles County Evidence of Self Insurance 2007