Allergy Consultants, P.A.

Specialists in Pediatric and Adult Allergy, Asthma, and Sinus Disease Arthur F. Fost, M.D. David A. Fost, M.D. Antonio A. de la Cruz, M.D. Mark E. Weinstein, M.D.

ORIENTATION CHECKLIST
(Each point must be signed of f by the person who is conducting the orientation or mentoring the new employee)

Employees Name: _________________________ Position: __________________ Date of Hire: ____________Introductory Period Evaluation Date: ______________ PERSONNEL DEPARTMENT _____ Application on file. _____ Resume on File. _____ Licenses verified, copied and on file (where applicable). _____ Confidentiality Agreement Signed. _____ Welcome Letter. _____ Personnel Information and emergency contact information completed. _____ Receipt of Employee Manual, explained, signed as accepted and understood. _____ Job Description and Organization Chart explained. _____ Performance Evaluations explained and date set for introductory period appraisal. _____ W-4 and W-9 forms completed. _____ State and Local Tax withholding forms completed. _____ Social Security number on file. _____ Copy of drivers license on file. _____ Health Insurance Application forms completed and eligibility of benefits discussed and when they commence. _____ Universal Precautions read and signed for. _____ Immunization form signed as accepted / refused. _____ Work permit on file, if applicable. _____ Alien Authorization Card, Employment Eligibility, Green Card Checked, copied. _____ Hours, work schedule, pay rate, pay days, overtime reviewed. _____ Attendance, including whom to notify (and when) in cases of absence and tardiness. _____ Key(s) to office given to employee, accompanying form signed, security procedures explained. _____ Office and Hospital Tour completed, car parking explained and shown. _____ Personal lockers shown and allocated and storage of personnel belongings explained. _____ Location of time clock and cards explained. _____ Posted Notices shown and explained. _____ Location of break room and breaks/lunches explained. _____ Location of parking explained. _____ Introduction to co-workers, including job titles of each. Written list of employees names and positions explained. _____ Dress code, appearance, hygiene discussed. _____ Explanation of where to enter/leave office and when and who will be in to open. the office and who will lock the office in the evening. _____ Telephone procedures discussed, including cell phone use. _____ Explanation of names and titles of physicians and how to address them. _____ Policy and Procedure Manuals explained and locations shown. _____ Safety Instructions for fire, evacuation, OSHA.
WWW.SNEEZEDOCTORS.COM

197 Bloomfield Avenue Verona, NJ 07044 (973) 857 0330 Fax (973) 857 0980

5 Franklin Avenue Belleville, NJ 07109 (973) 759 2029 Fax (973) 759 0403

89 Sparta Avenue Sparta, NJ 07861 (973) 726 8850 Fax (973) 726 8924

Allergy Consultants, P.A.

Specialists in Pediatric and Adult Allergy, Asthma, and Sinus Disease Arthur F. Fost, M.D. David A. Fost, M.D. Antonio A. de la Cruz, M.D. Mark E. Weinstein, M.D.

_____ Compliance Policy Manuals, HIPAA _____ Security precautions explained. _____ Opportunity for new employee to ask questions. POSITION SPECIFIC ORIENTATION BACK OFFICE 1. Nurse Practitioner 2. Medical Assistant FRONT OFFICE 1. Receptionist, check-in 2. Receptionist, check-out 3. Insurance Clerk 4. Billing Associate coding/claim filing 5. Billing Associate - posting 6. Practice Manager 7. Financial Officer Mentor/Employee Conducting Orientation Comments: ________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ __________________________________________________________________ Mentor Conducting Orientation: ________________________ (sign) Date of Completion of Orientation: ______________________________ Practice Manager: ______________________ Date: ______________________

WWW.SNEEZEDOCTORS.COM

197 Bloomfield Avenue Verona, NJ 07044 (973) 857 0330 Fax (973) 857 0980

5 Franklin Avenue Belleville, NJ 07109 (973) 759 2029 Fax (973) 759 0403

89 Sparta Avenue Sparta, NJ 07861 (973) 726 8850 Fax (973) 726 8924