House Staff Forms

House Staff Checkout Sheet
Must be completed and returned to the GME office in order to receive Final Paycheck. Final Paycheck is NOT a direct deposit.
Application for an Away Rotation
Notification of an Away Rotation
Malpractice coverage for House Staff working outside approved practice sites.
Reimbursement Form
Email/Fax Reimbursement Form to Tina Lari (650-723-3045 or
Request for Leave of Absence
Request for Live Scan Service