You will need the latest version of Adobe Reader to open these documents. This program is free. You may be able to electronically fill out the documents once opened, and save them on your computer if you have version 8.0 or higher. Filling out these forms electronically is preferred as it is legible and easy to send.
Applicants: Please fill out the
application below. If hired, we will instruct you to complete the
documents under the NEW HIRES section.
TDY
Medical
Staffing
Application
New Hires:
Please
complete
every
form below. Make sure to sign and date
where applicable. DO NOT fill out these forms until you have been
instructed to do so. Applicants do not fill these out until
hired.
Back
Brace Form
BackgroundRelease
Health
Status
Statement
Form
Hepatitis B
Statement
OSHAPreTest
Policy Substance Abuse
TB
Screening Form
IRS Form W-4
IRS Form I-9
Hippa
Manual
Hippa Test
Hippa
Agreement
Additionally, we will need a picture I.D., Social Security Card, Birth Certificate, BLS/ACLS (if applicable), PPD, transcripts when requested, Licenses (as required - MD, RN, PT, etc), other competencies/certifications required for your job.
VA Employees - VA Form 0711 is required
Current Employees - below are
forms you may need at some point during your employment:
Timecard
Must
be
filled
out every week by Noon on Monday. Failure to
complete on time may result in a delay in you getting paid. You
may electronically fill out the form on your computer using Adobe
Reader - this will make your copy legible. You can save the file
on your computer if you have Adobe Reader 8.0 or higher.
IRS Form W-4
Fill out anytime you want to change your filing status.
Employee
Incident Report - this form must be filled out for any incident
that is considered out of the ordinary. Examples - altercation
with someone, patient fall/injury/medication error, no-call no show to
facility, any disagreement with any persons at the facility you are
assigned to work.
EMPLOYEE INJURY - In the event of a serious injury, seek
emergency
medical care first. Contact us as soon as possible. If it
is not a medical emergency, please print the following documents and
follow company policy for seeking medical treatment:
Employee
Injury
Report - Employee please fill this out as soon as possible
Claims
Process
Medical
Treatment
Acceptance/Refusal
Letter
Injury
Reporting
Packet
You must follow TDY Procedures/Policies regarding work place
injuries. Please contact us if you have any questions.
For questions regarding anything on this page, please email kevin@tdymedical.com