Incoming Requirements

Mandatory Forms for ALL incoming Residents and Fellows

All incoming trainees must submit these forms no later than April 6, 2012. 

• All Inclusive Responsibility Statement
• BLS / ACLS / PALS Provider Course
• Data Responsibility Form
• Direct Deposit Authorization Form
• Osteopathic Training Application- DO NOT MAIL DIRECTLY TO BOARD OF MEDICINE
• Foreign National Information Form- Cover Sheet & Instructions*
• Foreign National Information Form*
• Health & Life Insurance Enrollment Forms
• I-9 Form
• Insurance Enrollment Verification Form
• Lab Coat Order Form               **Lab Coat Information Sheet**
• MD Training Application- DO NOT MAIL DIRECTLY TO BOARD OF MEDICINE
• New Resident Information Sheet
• NPI Application Instructions
• Resident Communicable Disease Form
• Resident Current Contact Information
• Retirement Certification
• Standard Beneficiary Form
• USMLE/COMLEX Scores- provide copies of Steps 1 & 2
• W-4 Form  

  *if applicable

Forms should be mailed to:

Graduate Medical Education

University of South Florida

Attn: Kristine Barry

12901 Bruce B. Downs Blvd., MDC 41

Tampa, FL  33612

Please refer to your WELCOME LETTER for direction on which of the following groups of forms you must complete.

Mandatory Forms for James A. Haley VA

• James A. Haley VA Forms

Mandatory Forms for All Children's Hospital

• ACH Map & Address
• Confidentiality Agreement
• Housestaff Profile Sheet
• Internet Agreement Form
• Key Access Control Requisition
• Medical Records Department Sample
• New Resident Information Sheet
• Remote Network Access Request
• Scrub Order Form

Mandatory Forms for Bay Pines VA

• Bay Pines Forms

Mandatory Forms for Morton Plant Hospital