REQUEST FOR OFFER
This form is used for office managers to request an offer letter from Human Resources.
Start Date
-
Month
-
Day
Year
Date
New Hire Name
*
First Name
Last Name
New Hire Email
*
example@example.com
Office Location
*
TRC-Corp
Garner-4042
Garner Kids & Ortho
Selma
Goldsboro
Benson-McGees
Clayton-Flowers
Knightdale
Wakefield
Durham
Mebane
Clemmons
Cary West (Maynard rd.)
Cary Family (Crescent green Drive)
Cary Kids
Apex
Raleigh Falls
Durham
Oxford
Wake Forest
Fayetteville (Rae.)
Fayetteville (Mel)
Wilmington (PN)
Wilmington (MJ)
Wilmington (SY)
Greensboro
Six Forks
Charlotte
Office Location
*
Manager's Email Address
*
example@example.com
Manager requesting offer
*
First Name
Last Name
Position
*
Dentist
Dental Hygienist
Hygiene Assistant
Ortho Assistant
Dental Assistant
Patient Coordinator
Insurance Coord.
Collections Coord.
Sterilization Tech
Office Manager
Treatment Coord.
Marketing
Facilities
Finance/Acctg.
IT
Human Resources
List position title if not listed above
Position type
*
Full-Time (more than 30 hours)
Part Time (less than 30 hours)
Seasonal (only used during summer or peak seasons)
Detailed of position-type (example: M-F work schedule) or T, W, Thursdays
*
Daily Arrival/Start time Expectation: (example: 6:30am, 7:45am, 8:00am, etc.)
*
If RDH, please confirm work model. Example : Blended - Monday (Double), Tuesday-Friday (Single)
What is the hourly rate or salary?
*
Has your Headcount been approved by Regional Manager or HR? (hint: manager should've requested headcount using headcount request form - process in 'MyTeams')
*
Yes
No
If this is a replacement, please enter the name of the employee this person is replacing. If not replacing anyone please enter 'N/A'.
Please upload a copy of candidate's resume (if applicable)
Browse Files
Cancel
of
Have you notified candidate of offer? (yes or no- provide details if you want Recruiter to present offer)
Has employee completed working interview? (want to know if candidate completed the working interview link to be added to Paycom)
Yes
No
Comments (Please note any additional comments that need to be added to offer letter, ex: training at another location, etc.)
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Working Interview Feedback
Date of Working Interview
*
-
Month
-
Day
Year
Date
Please describe candidate's alignment to our Core Values.
*
If clinical position, please describe candidate's clinical skillset. If non-clinical, please describe candidate's non clinical skillset.
*
Have you received provider feedback on this candidate?
*
Feedback from doctor:
*
What training would this candidate benefit from from within their first 30,60, 90 days?
*
Submit
Should be Empty: