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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 2011-2012
FY 2010-2011 Docs

IMPORTANT - Links beginning with a * have not yet been updated for the 2010-2011 academic year

2011 Paperwork Due Dates

New Hires

Checklist for New Hires Only

Cover Sheet for New Hire Packet-Budget Page

Per 2

New Hire Welcome Packet (Forms Only)

ILPH / HCSD Packet (Forms Only)  *if needed
See House Officer Document Page for individual forms

VA Resident Application *if needed

Agreement of Appointment

 

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

Checklist for Continuing House Officers

PER 3

Agreement of Appointment

 

Transferring House Officers
(Transferring from one LSU program to another, including EKL and UMC)

Checklist for Transferring House Officers

PER 3

ILPH / HCSD Packet (Forms Only)  *if needed
See House Officer Document Page for individual forms

VA Resident Application *if needed

Agreement of Appointment

Extra-Curricular Form

 

Terminating House Officers

Checklist 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

Release Data From LSU (if resident transferring to a non-LSU program)

 

Promote / Transfer / Terminate Spreadsheets

Promote

Promote & Transfer

Terminate

Transfer

Becoming Faculty

 

Other Forms

Resident Appointment Form

Fellowship Appointment Form

Release Data From LSU

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

 

Medical School Visiting House Officer - Observing

Documents for Observing Visiting House Officer (Revised December 2011)

Data Sheet for Visiting Residents and Fellows (Revised December 2011)

Visiting House Officer – LSU Interim Hospital Appointment Form

Sample Letter for Observing visiting resident

 

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)

Visiting House Officer – LSU Interim Hospital Appointment Form

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

 

Dental School Visiting House Officer - Observing

Documents for Visiting House Officer – Observation – Dental School (Revised January 2012)

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

Visiting House Officer – LSU Interim Hospital Appointment Form

Sample Letter for Observing Visiting Resident – Dental School (Revised January 2012)

 

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)

Visiting House Officer – LSU Interim Hospital Appointment Form

 

Drug Testing Instructions