beth israel deaconess medical center a harvard medical school teaching hospital

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Occupational Health

In order for your application to be finalized, the following information is required to meet BIDMC requirements, which are based on the following: state and federal regulations; Joint Commission Standards; and Infection Control policies. Your application will not be processed until all required documentation listed below is received and approved by Employee/Occupational Health. This information is necessary so that we may protect both our patient population and you from potential infections of public health significance.  The below forms will be provided to each trainee by the program coordinator.

1. You must gather from your medical provider the official documentation of your immunizations as requested on the form. Complete the bottom of the form and fax all info to 617.632.0906 and send originals to your program coordinator.

2.  Please accurately enter all information requested in this pre-placement form.

3.  Fill in employee information at the top of the form and answer all questions.