Employee On-boarding Form Required Information* New Hire RE-Hire Department Transfer Employment Status Per Diem ( CM / WC ) Full Time Regular Part - Time (25 hours per week) Irregular Part - Time (Variable hours) Employee Name* First Last Preferred Pronouns She/Her He/Him They/Them Start Date* MM slash DD slash YYYY Orientation Date* MM slash DD slash YYYY Position*Is this an Office Role? Yes No If yes, where will they be seated (please indicate phase and location of desk)Is this a client facing role? Yes No If you have select CM or WC please define the populations they will serve Select All Child Adult Please list credentials that should be attached to their signature in EHR (If applicable)Manager/Supervisor*Manager/Supervisor Email* What Systems do they need access to?* Email/Secure Email Add to HAMWORKERBEE Directory Sharepoint - Employee Intranet Atrezzo EIS WITS ZenDesk Hamworkerbees email Ability to scan from printers Spreadsheet Access on H Drive EHRYW ZIX Portal Crisis Chat Group Additional E-mail Distribution Groups NeededSpecific document libraries needed on sharepoint (alternatively known as access level) within specific departmentEHR Access - Please indicate a current or previous user that you would like the new users access to be copied from.Hardware* Work Cellphone Verizon Hotspot U.S. Cellular Hotspot Laptop Desktop Computer Computer/desktop headset Desktop Printer Desktop Scanner Webcam Human Resources Written offer letter Case Manager Orientation Case manager directory in sharepoint Ergonomic check (Office Staff) Benefits meeting Paylocity Time Clock (hourly Employees) Paylocity Supervisor Time and Attendance Office Key/Access Pass ID Badge Business Cards Cubical Name Tags Additional Supplementary Onboarding Training Crisis/De-escalation for non-clinical Staff OtherIf anything not listed is needed, please describe here.For Internal Transfers Only - Please list any previous e-mail groups, lists, folders, sharepoint groups/access, systems, hardware, software, etc. from their previous position that will no longer be needed.If anything not listed is needed, please describe here.
