Registration Materials
Registration materials must be completed prior to the start of your residency and submitted to the GME Office by May 19, 2023.
Please do not stop by the GME office prior to May 1. You may park in the Hamilton Eye Institute garage when you are visiting our office.
Return complete materials to:
haley@uthsc.edu
Must be a clean scan with original signature.
Or mail to:
University of Tennessee Health Science Center
Graduate Medical Education
Attn: Haley Smith
920 Madison Avenue. Suite 447
Memphis, TN 38163
Complete and Return Immediately
- Registration
- Competency Information
- Disability Disclosure
- Immunization Requirements
- Health Statement
- NPI Instructions / Number Link
Complete and Return Once You Have A Local Address
- Personal Data
- Life Insurance
- Medical Society Application
- W-4 Form
Complete at Orientation
- Disability Insurance Program
- Disability Insurance Plan Summary
Government Registration
- AR Medicaid Practitioner ID Number Request
- MS Medicaid Act / MS Medicaid Screenshot
- CSMD FAQs
- Controlled Substance Monitoring Database (June 1)
Other
- Truescreen Background Check (April-Email)
- Appointment-Review Only (June-DocuSign)
- Health Insurance
- Bernieportal Login
- Bernieportal Benefits/Enrollment
- Bernieportal App
- Health Insurance Marketplace Coverage Options
- Outside Interests Disclosure (May 1-Email)
- PECOS Information / Registration (May)
- Direct Deposit (July 1-Email)