New Clinician Orientation Enrollment Form FY25

Please use this form when enrolling new clinicians in New Clinician Orientation.


Please note, orientation dates are available first come, first serve. Please submit your forms as soon as you know you have someone starting.


PLEASE NOTE: New Clinicians CANNOT attend NCO or eStar training until their start date due to the Fair Labor Standards Act.

 

LEGAL FIRST NAME - DO NOT PUT PREFERRED NAME

 

Enter name shown on government identification (legal name)

 

If their VUMC ID has not been created yet, please put the expected date the VUMC ID will be activated.

 

Please provide a personal and VUMC email address for communications regarding NCO (if they do not have a VUMC email please enter their personal email) *DO NOT enter an email address associated with their current employer*


Please use a semicolon ";" to separate each email address.

 

***If your new provider is a Clinical Fellow/Instructor going through GME onboarding, PLEASE ensure you choose the correct option, i.e. GME Clinical/Fellow/Instructor and not MD, DO, OD.

 
 
 
 
 
 
 
 
 
mm/dd/yyyy
 
 
mm/dd/yyyy
 
 
 
mm/dd/yyyy
 
 
 
 
 

Providers may be eligible for abbreviated eStar Training.

 

Please choose all applicable courses for your clinician.

 

First Name Last Name

 
 

First Name Last Name