This is only here to make the top boarder show correctly
NEW HIRE FORM
THIS FORM MUST BE COMPLETED BY MANAGERS ONLY
Manager First Name
Manager Last Name
Manager E-Mail Address
Manager Phone Number
New Hire First Name
New Hire Last Name
New Hire Position
New Hire Start Date
Homesite
--Choose a location--
Anniston
Central Billing Office
Corporate
Demopolis
EmergiCare
Fort Payne
Gadsden
Gadsden Billing Office
Home Office
Hub
IATW
Jasper
Montgomery
Selma
Surgical Specialists
Sylacauga
Tuscaloosa Clinic
Tuscaloosa Urology
University Surgical Associates
Winfield
Additional Location 1
--Choose a location--
None
Anniston
Central Billing Office
Corporate
Demopolis
EmergiCare
Fort Payne
Gadsden
Gadsden Billing Office
Home Office
Hub
IATW
Jasper
Montgomery
Selma
Surgical Specialists
Sylacauga
Tuscaloosa Clinic
Tuscaloosa Urology
University Surgical Associates
Winfield
Additional Location 2
--Choose a location--
None
Anniston
Central Billing Office
Corporate
Demopolis
EmergiCare
Fort Payne
Gadsden
Gadsden Billing Office
Home Office
Hub
IATW
Jasper
Montgomery
Selma
Surgical Specialists
Sylacauga
Tuscaloosa Clinic
Tuscaloosa Urology
University Surgical Associates
Winfield
Additional Location 3
--Choose a location--
None
Anniston
Central Billing Office
Corporate
Demopolis
EmergiCare
Fort Payne
Gadsden
Gadsden Billing Office
Home Office
Hub
IATW
Jasper
Montgomery
Selma
Surgical Specialists
Sylacauga
Tuscaloosa Clinic
Tuscaloosa Urology
University Surgical Associates
Winfield
Enter alarm code if needed
Will a new Laptop computer need to be purchased?
--Please choose--
Yes
No
Will a new Desktop computer need to be purchased?
--Please choose--
Yes
No
How many monitors will need to be purchased for this user?
--Please choose--
0
1
2
3
Choose the applications required for the New Employee:
Viecure
Unlimited Financials
iSalus
Consensus
Nextgen
Monaco
Mosaiq
Radcalc
Aria
Eclpise
Additional Information / Comments:
This is only here to make the top boarder show correctly
