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Contact

Office of Medical Education
2020 Gravier Street
Suite 602
New Orleans, LA 70112
Phone: 504-568-4006
Fax: 504-599-1453

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Office of Medical Education

Program Coordinator Documents
FY 2015-2016
FY 2014-2015 Docs

IMPORTANT - Links beginning with a * have not yet been updated for the 2015-2016 academic year

2015 Due Dates for Paperwork & Drug Testing

Errors to Avoid when Submitting Paperwork

Instructions for Completing New-Year and End-Of-Year Paperwork

I-9 Acceptable Documents

New Hires

Checklist for New Hires Only

Cover Sheet for New Hire Packet-Budget Page (Program Coordinators Only)

Per 2 (Pre-Populated Per 2)

New Hire Welcome Packet (to be completed online)

ILPH / HCSD Packet  *if needed
See House Officer Document Page for individual forms

VA Resident Application and Documents - New Residents* *if needed
Contact Ms. Janice Williams at 504-565-4873 with any questions about VA forms.

Agreement of Appointment (Program Coordinators Only)

 

Incoming Transfers From Other Institutions (Including LSU Shreveport)
These forms should only be used when a House Officer will be receiving credit for training done at another institution (exluding required prerequisite prelim years).
NOTE: These forms must be completed and approved by GME before a position may be offered to the applicant!

Checklist for Trainees – Transfer from Other Institution

Data Sheet – Transfer from Other Institution

Transfer Applicant Program Director Questionnaire

Release Data to LSU

 

Continuing House Officers

Instructions for Continuing House Officers

PER 3

Agreement of Appointment (Program Coordinators Only)

LSBME Release

VA Training Information and Acknowlegement Form- Returning Residents* *if needed
Contact Ms. Janice Williams at 504-565-4873 with any questions about VA forms.

 

Transferring House Officers
(Transferring from one LSU program to another, including UMC-Lafayette)

Checklist for Transferring House Officers

GME Data Sheet

PER 3

ILPH / HCSD Packet  *if needed
See House Officer Document Page for individual forms

VA Resident Application and Documents - New Residents* *if needed
Contact Ms. Janice Williams at 504-565-4873 with any questions about VA forms.

VA Training Information and Acknowlegement Form- Returning Residents* *if needed
Contact Ms. Janice Williams at 504-565-4873 with any questions about VA forms.

Agreement of Appointment (Program Coordinators Only)

Extra-Curricular Form

FCVS Form

LSBME Release

 

Terminating House Officers

Instruction Sheet for Terminating House Officers

PER 3

ILPH Check Out / Medical Record Reassignment Forms *if applicable

LSU Personal Data Change Form

Exit Survey (for House Officers completing or resigning from programs)

Program Separation Packet (Actions needed by resident before separation)

Post Program Completion Packet

 

Promote / Transfer / Terminate / Off-Cycle Spreadsheets

Promote, Transfer, and Terminate (Auto-populated from New Innovations)

Transfer without Promotion (must be manually completed)

Off-Cycle (must be manually completed)

Becoming Faculty (must be completed manually)

 

Other Forms

Residency / Fellowship Appointment Form (Auto-populated from New Innovations)

Release Data From LSU

VA TQCVL (Resident Credential Verification Letter)*
(Sample Completed Letter) Contact Ms. Janice Williams at 504-565-4873 with any questions about VA forms.

Certificate Order Form

Malpractice Form

 

Medical School Visiting House Officer - Patient Care

Documents for Visiting House Officer - Patient Care (Revised January 2012)

Data Sheet for Visiting Residents and Fellows (Revised January 2012)

ILPH / HCSD Appointment Packet (separate documents available here)

Sample Letter for Patient Care visiting resident (Revised January 2012)

Pelican / EPIC Training Request Form

 

Dental School Visiting House Officer - Patient Care

Documents required for a visiting House Officer – Patient Care – Dental School (Revised January 2012)

Data Sheet for Visiting Residents and Fellows – Dental School (Revised January 2012)

Sample Letter for Visiting House Officer-Patient Care – Dental School (Revised January 2012)

ILPH / HCSD Appointment Packet (separate documents available here)

Pelican / EPIC Training Request Form

 

Drug Testing Instructions