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Forms
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Vacation and Sick Leave
Resident Leave Request
(use to request vacation and sick leave)
School of Medicine Leave Request (use if you are applying for extended
leave for child birth or leave without pay)
USMLE Leave Policy (Internship
Only)
USMLE Leave Request (Internship
Only) (use to request leave during a medicine rotation to take your
USMLE)
The Top Ten
Documentation of Preceptor Contact
(due semi-annually.)
Direct Deposit (use to establish
or change the direct deposit of your paycheck. Takes 2-3 pay periods.)
Duty Hours Form (on Verinform)
Evaluation
& Competency Forms
Log Summary (due quarterly)
Medical
License Forms
Outside
Professional Activities Disclosure (Moonlight) Form (to obtain approval
for moonlight)
Rites
of Spring forms
TB Test Record (use to document
your annual TB testing requirement)
USMLE Step 3 Application
& Post-graduate Verification form
More Obscure Forms...
Mock Board Evaluation (faculty
administering mock boards should use this form to grade residents)
Interview Report of Psychiatry Residency
Applicant (use to evaluate applicants to the program)
Residency
Position Appointment Signature Form
Residency
Position Appointment Agreement Appendix
Student Loan Deferment Request
(may be used for all federal student loans including those administered
by SallieMae)
7N Admissions Screening
Aid (guide for screening patients to 7N)
W-4 Employee's Withholding Allowance
Certificate (use this to change the amount of tax withheld from
your paycheck)
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