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Clinical Assignment Request

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Union Status:
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(Please print title *must be manager/supervisor level)
(If no reason given, form will be sent back)
Does the temporary need to be EPIC trained?
Please note: Intrastaff can schedule basic EPIC courses. Department specific will be scheduled and paid for by department.
**Temporary has to work a minimum of 12 weeks before being hired by any affiliate.

Billing Information (*required to provide):
Managers are responsible for approving temp labor hours weekly by 1pm each Monday.
* If you do not have access to Kronos or Lawson for timekeeping purposes, please notify the Intrastaff Staffing Coordinator
Reminder: Per JHHS policy HR-100, temporary employees shall not be employed in an assignment for more than six months except during exceptional circumstances with the approval of the Office of HR Consulting and Labor Relations.
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