Documents Needed

For Providers – License number, NPI number and DEA number and title (M.D. or O.D., etc.)

1. Documents that establish both identity such as:

  • Passport
  • Permanent Resident Card
  • Driver’s license or ID

2. CPR Card

3. Immunization Record with the following completed:

  • MMR (if born after1957)
  • Varicella
  • Hepatitis B

4. TB Skin Test. If positive, Chest X-Ray Report is needed.

5. Complete Employee Application

6. Copy of license(s) and/or certification(s)

 

For regulars/volunteers/interns

1. New Hire Information Sheet
2. Completed I-9 and documents to establish ability to work in U.S.A.
3. W-4 Tax Form – DE-4