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Employee & Other Forms

For Existing BMC Employees Only

 

BMC-HR001  New Staff Info.pdf

Purpose

To request access to one or more of the following for a new or an existing employee;

-          BMC Employee Portal and Punch Clock,

-          eCW (EMR/PM System)

-         PRManager (Outgoing Referral Manager)

How to Submit

Click on the Form link and once it opens on your screen, complete respective parts, Print and get necessary local office approvals.  Scan and attach to an email from an official BMC Exchange account then send to operations@carebmc.com

 

 

BMC-HR002 Leave Application.pdf

Purpose

To apply for all kinds of leave(s) of absence for all staff members including staff providers.

How to Submit

Click on the Form link and once it opens on your screen, complete respective parts, Print and get necessary local office approvals.  Scan and attach to an email from an official BMC Exchange account then send to operations@carebmc.com

 

 

BMC-HR003 New Provider Info.pdf

Purpose

To request access to one or more of the following for a new or an existing Staff Provider Only.  Data in this form must be verified by Credentialing prior to processing;

-          BMC Employee Portal and Punch Clock,

-          eCW (EMR/PM System)

-          PR Manager (Outgoing Referral Manager)

How to Submit

Click on the Form link and once it opens on your screen.  Print the form.  Complete, in black ink.  Scan and attach to an email from an official BMC Exchange account then send to operations@carebmc.com

 

 

DHS Form I-9 - Employment Eligibility Verification

Purpose

To be completed and submitted to Operations by all individuals seeking employment at Best Medical Care, PC.

How to Submit

Click on the Form link and once it opens on your screen, complete respective parts, Save a copy on your Desktop and then close.  Attach to an email from an official BMC Exchange account and send to operations@carebmc.com

 

 

 

IRS Form W-4 - Employees Withholding Allowance Certificate

Purpose

Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay.  Consider completing a new Form W-4 each year and when your personal or financial situation changes.

How to Submit

Click on the Form link and once it opens on your screen, complete respective parts, Save a copy on your Desktop and then close.  Attach to an email from an official BMC Exchange account and send to operations@carebmc.com

Other Forms 

HIPAA OCA Official Form 960

Purpose

Authorization for release of health information pursuant to HIPAA.  To be completed and signed by the lawful owner of the health information and to be submitted only after positive identification of the subject.

How to Submit

Click on the Form link and once it opens on your screen, complete respective parts, Save a copy on your Desktop and then close.  Attach to an email from an official BMC Exchange account and send to operations@carebmc.com

 

 

Clinic Coordinators Checklist

Purpose

To be completed and submitted weekly by the clinic coordinator only.

How to Submit

Click on the Form link and Print it.  Complete, in black ink.  Scan and attach to an email from an official BMC Exchange account then send to operations@carebmc.com

 

 

 

BMC Incident Reporting Form

Purpose

As and when needed, to be filed by any staff needing to report any incident of non routine nature. 

How to Submit

Click on the Form link and once it opens on your screen, complete respective parts, Print and get necessary local office approvals. Scan and attach to an email from an official BMC Exchange account then send to mic@carebmc.com

 

 

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