GME Registration Materials
We have included all of the documents that must be completed prior to the start of your residency. Please complete the forms and return to the GME Office by May 13, 2016. Please note that in addition to the forms listed below there is an addition document called the I-9 that must be completed in person before you can be placed on payroll.
Also, please note that all employees of the University of Tennessee are required to have payroll direct deposit. If you come the GME Office please bring with you a voided check, otherwise please bring to Orientation.
ALL FORMS MUST BE RETURNED BY MAY 13, 2016.
RETURN ALL REGISTRATION MATERIAL TO:
University of Tennessee Health Science Center
Graduate Medical Education
Attn: Janie Hall
920 Madison Avenue Suite 447
Memphis, TN 38163
- GME Orientation Checklist
- Agreement of Appointment (Review Only)
- Criminal Background Check Form
- Registration Form
- Personal Data Form
- Competency Information Form
- Health Insurance Enrollment Form
- Health Insurance Declination Form
(if declining UT health insurance)
- Life Insurance Form
- Disability Insurance Information
- Outside Interests Disclosure Form
- Immunization Record
- Health Statement Form
- Direct Deposit Form
- Memphis Medical Society Application
6019 Walnut Grove
Memphis, TN 38120
- Baptist Registration Information
- Orientation for Non-Employees
- Baptist Campus Map #1
- Baptist Campus Map #2
For general GME questions, please contact Andrew Gienapp: Andrew.Gienapp@mlh.org.
Computer Access: There is no MUH paperwork for you to complete for computer access; MUH will receive
your personal information from the UT GME office.
New residents/fellows coming to Methodist University Hospital (MUH) will receive their ID number and Cornerstone login credentials for training via email in early June.
For issues related to Cornerstone access after you receive your Cornerstone login credentials, contact Pam Thompson or call the Medical Informatics Education Line at (901) 516-0369. For faster response time, please use email.
Badging: After you complete your Cornerstone training, you can get a badge from Methodist security (Centracom).
Location: the Centracom office on the ground floor behind the Medical Staff Auditorium. Knock on the door for entry.
Hours of Operation: Mon–Fri, 8:00 am to 4:00 pm
If no one available, call the main security line: (901) 516-7765
Centracom will make both University and Le Bonheur badges for residents rotating at both hospitals.
Parking Sticker: Complete the Parking form and give to security personnel in the Centracom office.
- Acceptable Forms of ID for I-9
- AR Medicaid Practitioner ID Number Request Form
- MS Medicaid Act
- MS Medicaid Screenshot
- NPI Instructions
- NPI Number Link
- Campus Map
- Controlled Substance Monitoring Database
- PECOS Information
- PECOS Registration
Mail forms to the address listed on the form.
Regional One Health
877 Jefferson Ave.
Memphis, TN 38103
- Resident Orientation Welcome Packet
- Request for ID Badge
- Training for Physicians
- System Descriptions
- Blood Transfusion Module
- Policy Updates
- Compliance Training
- Compliance Summary
- Access to Computer Systems
- Wireless Access
- Apple Wireless Setup
- IT Contacts
1030 Jefferson Avenue
Memphis, TN 38104
- VA Declaration
- VA Application
- VHA Mandatory Training for Employees
- VA Fingerprint Record
- VAMC Paperwork Pointers
- Instructions #1
- Instructions #2
- VHA Training Screen Shots Note: Be sure to record your chosen username and password for future use. Take the course, print off your certificate, and keep it for presentation to the VA. Please call Elston Howard at (901) 577-7207 with any questions.
- VA Contacts for Compliance Documents
Office of Graduate Medical Education
Eugene Mangiante, MD
Executive Associate Dean
920 Madison Avenue
Memphis, TN 38163
Phone: (901) 448-5364
Fax: (901) 448-6182