New Hire Intake

01

Employee

First Name *

Last Name *

Preferred First Name

Optional. Defaults to First Name if blank.

Personal Email *

Used for the welcome email only.

Start Date *

Employment Type *

Role / Job Title *

Department *

Manager Name *

Manager Email *

Work Location *

Clinic = works at a clinic site. Onsite = main office. Remote = works from home.

02

Computer Type

Monitor Count

Cell Phone

Yes No

MiFi

Yes No

Accessories

Power Adapter Docking Station Keyboard / Mouse Carrying Case USB Device Other

03

EMR Access Needed

Yes No

Fax Needed

Yes No

Additional O365 Groups

Comma-separated. Everyone gets All-Caduceus automatically — list only extras.

Shared Mailboxes

Comma-separated email addresses.

04