This partially fillable form will help us learn a few details about you/your family as well as your driver's license status and your life support certification status.
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Form 3 - Resident and Fellow Information
Send to Amy once completed
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Marshfield Clinic Health System runs a background information record on each employee. This form initiates that process. |
Form 4 - Background Information Disclosure
Send to Amy once completed
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A form specific to your legal name. Let us know how you would like your name used throughout the system. Please note, some of our apps have a "cap" regarding the number of letters for inserting names (i.e., if you have a long name). |
Form 5 - Name Documentation
Send to Amy once completed
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If you need information about visa applications, please reach out.
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Michael Roherty (Residency & Fellowship Programs Manager)
roherty.michael@marshfieldclinic.org
and/or
Antoinette Wijayapala (Education Programs Specialist)
wijayapala.antoinette@marshfieldclinic.org |
The MCHS Employee Health Department uses the 'paperless' program "ReadySet" to store all of your health information. As a new employee of MCHS, you will need to set up your personal account. If you stumble on the instructions, reach out to your coordinator
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Ready Set Instructions
Employee Health Requirements Letter
Attachments 7, 8 and 9 on checklist
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Also related to MCHS Employee Health, you need to complete a pre-employment visit prior to your start date.
| Please contact your program coordinator to get that arranged. They're nice people and they will help you get this scheduled. :) For fellows, this "visit" might be a virtual arrangement based on commitments you have with your current organization.
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Each of you will need a photo taken that will show up in directories, pictorials, PowerPoints, etc. during your time here.
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Preparing for Your Photo - Instructions
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Each year, a pictorial is created with a photo of each trainee. You will be part of the next pictorial publication.
| Current 2022-2023 resident/pictorial
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This is another document you do not need to fill out, but if you are a non-citizen and in need of establishing a social security number, this might be helpful information.
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Social Security Information for Non-Citizens
Social Security Office Location:
2213 8th Street South
Wisconsin Rapids, WI 54494
Phone number: 1-855-686-1465
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Speaking of your driver's license, the information you see on this PDF (right box) might be useful.
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Wisconsin Driver's License Information
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This is a document that you don't need to fill out, but you will find helpful information about the city of Marshfield, including apartments, housing realtors, etc.
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Marshfield Area Housing Resources
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