New Hire Form Dental Medicine

This form is used to initiate onboarding requests for new employees within the School of Dental Medicine. It collects the information needed to provision accounts, access, equipment, and services for a new hire.

Please enter the name of the new employee

Please enter in the name of the new employee

Please enter the working title of the new employee

Please enter in the job title of the new hire

Please select the new employee effort level

Please select the primary job classification of the new employee

Please select the primary classification of this new hire

Please select to which responsibility center this employee belongs

Please enter the home responsibility center of the new employee.

31 - School of Dental Medicine

Please select the hiring department within RC 32

Please select the hiring department within RC 33

Please select the hiring department within RC 35

Please select the hiring department within RC 39

Please select the hiring department within RC 85

Check which services this developer needs

Confluence

FPE Test

FPE Prod

GitHub

JIRA

Pentaho

Does this new employee need Dental EHR (OurRecords) access?

Does the new hire need EHR access?

Select all required dental software required

Please select which Dental EHRs this individual needs to access

axiUm

axiUm Simulation

DemandForce

Intiveo

Invivo

UDHS Dentrix

UDHS MiPACS

Account to mirror access from (If applicable)

Does the new hire have a pre-existing Pitt account?

Does this person already have a Pitt account?

Please provide the new hire's Pitt email address

Please provide the email address of the new hire

Does the employee need phone access?

Please select any options that this employee may need.

Select all phone options that apply

Please select requirements for phone usage

Individual Phone Number

Amazon Connect Group Queue

Microsoft Teams Call Queue

Private/Masked Caller ID

Please enter the new employee office number, if possible

Expected Start Date

Please enter in the expected start date of the new hire. This is the new hire's day one at the university.

Does this new employee require equipment? (If yes, specify in the comments section)

Title

A short description to explain the nature of a ticket.

Description

The full details of a ticket, including any appropriate circumstances or supplementary information that may aid in resolving it.

Attachment

File attachments associated with the ticket.

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Other Fields

Your name

Your email address

Verification Code