Online Orientation Packet

Graduate Medical Education Forms

• Residency Appointment Acceptance Letter
• Life Support Certification Class Registration Form and/or copies of life support certification cards
• Parking Permit Request
• Duty Hours Agreement
• Texas Medical Association Insurance Trust (TMAIT)
• Texas Medical Association (TMA)
• TAMU-User Agreement (NetID Account Form)
• Waiver for Texas Physician-In-Training Application
• Waiver for Drug Screening (Fill in information and initial both urine and oral swab blanks)

Scott & White Employment Forms

• Employment Application Instructions (Please read/print before proceeding to Online Employment Application)
• Online Employment Application
• Resident/Fellow Packet (contains Data Capture Form, Application Disclosure Release and Network System User Agreement)
• Building Access Control Agreement
• Immunization Record (signed by Health Professional)

Scott & White Benefits Information

• Benefits Overview
• Medical Plan Overview
• Dental Plan Overview
• Medical and Dental Premium Rates

Forms that need to be returned at orientation (June 29) (Permanent address required)

• Direct Deposit Form
• W-4 – Witholding Allowance Worksheet
• I-9 – Employment Eligibility Verification
• Data Capture Form (located in the New Hire Packet)
• Medical Insurance Enrollment Form OR Declination Form
• Optional benefits enrollment forms:
  • Dental Insurance Enrollment Form
  • Lincoln Financial Group Insurance Form (Enroll for Accidental Death & Dismemberment Insurance)
  • Flex Spending Account Enrollment Form

Forms by Specialty

• Respirator Fitting Form - If your specialty is Anesthesiology, Emergency Medicine, Family Medicine, General Surgery, Infectious Disease, Internal Medicine, Pathology, Pediatrics, Pulmonary Critical Care or Radiology.
• Scrub-EX Form - If your specialty is Anesthesiology, Cardiology/Interventional Cardiology, General Surgery, OB/GYN, Ophthalmology, Orthopedic Surgery, Plastic Surgery, Podiatry or Urology.
• CR Darnall Army Medical Center – Electronic Personnel Security Questionnaire SF85P - If your specialty is Family Medicine.
• Central Texas VA Application - If your specialty is Anesthesiology, Dermatology, Endocrinology, Family Medicine, Gastroenterology, General Surgery, Internal Medicine, Medical Oncology, Ophthalmology, Pathology, Plastic Surgery, Psychiatry, Pulmonary Disease/Critical Care, Radiology, Podiatry, Urology or Vascular Surgery.
  You will need to go to the CTVHCS web site, if you have any questions regarding the CTVHCS forms please contact Nancy Beimer at nancy.beimer@va.gov.

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