Forms

1. Tax Forms (Federal and City/State) -- please return both forms even if you do not live in New York City or State
   1. W4
   2. IT-2104
2. I-9 Form  (Employment Eligibility)
3. Lab Coat Requistion Form
   1. 4 coats per person
   2. Choose a numbered size (i.e. 8 or 10, not Small).  Your order will NOT be processed if you write Small, Medium or Large.
4. Direct Deposit (DD) Enrollment Form
   1. Attach a voided check
   2. You may switch banks at any time
   3. Please note that not all will be on DD by July 1
      (If you do not have a social security number they will not put you on DD)
5. Pre Employment Physical Examination
6. CIS Form

   1. Fill out 1st box on page one
   2. Print and sign (in 3 places) on the 2nd page
   3. Please send back to House Staff for approval
7. Primary Source Medical School Verification
   For American medical school graduates ONLY
8. Verification of Post-Graduate Training
   Please fill out one form for each institution that you were affiliated with.
9. Conflict of Interest Disclosure

For general questions or to make an appointment, contact us at
(718) 920-9226.