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Human Resources Section

Human Resources Forms

The forms listed below are required as part of the hiring process. The GME New Hire Form is completed by the hiring department and the remaining forms are completed by the new hire. Once completed, please return all Human Resources forms to Keri Gilliespie in Human Resources at 375 Longwood Ave, 3rd Floor, Boston, MA 02215. The documents required to complete the I-9 Form and CORI Background check will be collected on the day that the new hire attends New Employee Orientation.


GME New Hire Form : Completed by employee's department. A submission deadline will be established for some time in mid May to ensure that HRIS has sufficient time to process the new hires onto our payroll system.

GME New Hire Form


Employment Application : Must be fully completed by employee (not completed by dept and signed by employee). The original of this form is highly preferred, however, a copy will also be accepted and must be signed by the employee (an electronic signature is not accepted).

Employment Application


Employment Eligibility Verification : The employee must complete Section 1 only -- up to and including employee signature and date. The remainder of the form must be completed by Human Resources.

The originals of the work authorization documents must be viewed by a Human Resources representative and, similar to the background check identification document, the originals will be viewed and copies made on the first day of orientation by Human Resources.

The employee may complete Section 1 and the form may be submitted to Human Resources pending receipt of the work authorization documents. Please be aware that an employer is required to validate work authorization within 3 days of employment. If this process is not fully and satisfactorily completed within the first 3 days of employment, the employee is subject to interrupted continued employment and/or termination.

Employment Eligibility Verification/I-9 Form


Background Check and Summary of Rights :  Incoming trainees must undergo a background check and consumer report inquiry; please find all necessary documents below.  The New Hampshire CORI Form need only be completed by trainees who currently reside in New Hampshire or have resided there during the past 7 years.  Please note that the New Hampshire form requires notarization and we must receive the original of this completed and notarized form.  Each of these completed forms must be hand signed by the employee (an electronic signature is not accepted).

The background check process requires a copy of a Government Issued Identification Document, such as a passport or social security card . A CORI-Certified Human Resources employee must view the original of the identification document and make a copy of this document. Human Resources staff will be available on the first day of each Housestaff Orientation outside the Sherman Auditorium and equipped with a copy machine to make these copies.

The completed background check forms may be submitted to Human Resources pending receipt of the Government Issued Identification Document.

Criminal Offender Record Information (CORI) Form
CORI Request Form
New Hampshire CORI Form
CORI Instructions:  Background Checks and Inquiries
FCRA- Consumer Report Disclosure and Release
FCRA- Written Notice and Authorization for Investigative Consumer Reports
FCRA- Summary of Rights


State and Federal Tax Forms : Our Payroll Department views the State and Federal tax form as separate forms and both must be completed to ensure appropriate deductions are taken based on the employee's selections. Some companies require only the Federal tax form be completed and they apply the same selections to the State tax form, however, we do not. If either of the two forms is not fully completed and submitted to Payroll, the employee will be defaulted to single zero.

An employee has the option to change their tax status at any time during the course of their employment and these forms are available on the General Portal under Payroll. Also, Human Resources does not require these completed forms as part of the on-boarding process, therefore, Human Resources will not follow up with the department or employee for any missing State or Federal tax forms.

Foreign Nationals: The Foreign Nationals Welcome Memo is from the BIDMC Tax Department and pertains to staff who are with BIDMC on a visa. We encourage foreign nationals to contact Toni Mansfield to determine if they are eligible for tax exemptions.

W-4 Federal Tax Form, 2011
M-4 MA State Tax Witholding Exemption Form, 2011
Foreign Nationals Welcome Memo

Social Security Number : A foreign national who does not yet have a social security number will be assigned a temporary social security number by Human Resources for the purposes of entering them into our payroll system. This temporary social security number is for BIDMC purposes only and must not be used for external reasons.

The foreign national is also required to provide Human Resources with a receipt (a copy is acceptable) from Social Security Administration (SSA) to confirm their application for a social security number. When the employee receives their social security number issued by SSA, they must provide Human Resources with the SSA issued number (we don't need to see the card) and a correction will be processed in our payroll system.

Below is a printout of information from the website www.socialsecurity.gov

Social Security Info


BIDMC Post-Offer Invitation to Self-Identify : All employees should complete this form; a copy is acceptable.

BIDMC Post-Offer Invitation to Self-Identify