NEW PROVIDER PRE-ORIENTATION CHECKLIST
STEP ONE
PROVIDER NAME: _______________________________________ MD DO PA NP
(First Middle Last)
PROVIDER SPECIALTY: _____________________________
ANTICIPATED START DATE: ORIENTATION:__________________ PATIENTS:______________
CLINIC LOCATIONS: ___A ___B ___ C ___ D ___ F ___
(Check Primary Location)
Task Description Party Responsible Date Completed Notes/comments
PHYSICIAN SERVICES
Return employment
agreement to physician __________________ __________________ __________________
Process signing bonus/
promissory note __________________ __________________ __________________
Send welcome letter
to physician __________________ __________________ __________________
Initiate internal
announcements
providing notification
of new provider __________________ __________________ __________________
Notify department
chair (Hospital)
Notify credentialing __________________ __________________ __________________
Notify credentialing
coordinator (Hospital) __________________ __________________ __________________
Initiate relocation
assistance to provider
(if needed) __________________ __________________ __________________
Resume Templates 1210 Document(s)
