UK HealthCare New Provider Orientation Registration

Please be sure to complete the provider orientation registration form in its entirety as the information will also be used for badge printing purposes. The deadline to register is noon on Thursday before the session.

If you have any questions, please feel free to contact Enterprise Learning, 859-257-9226.

Your name *

Your email address *

Your phone number *

Provider Information

Provider first name *

Provider middle name

Provider last name *

Provider email *

LinkBlue ID

UK employee ID number

NPI Number

Provider cellphone number *

Title *

Degree *

Division/section name *

Department name *

Will this provider see patients in an outpatient clinic?

Yes

Will this provider see patients in the hospital?

Yes

Has this provider been a UKHC employee in the past (including Good Samaritan, Chandler, etc.)?

Yes

If yes, please provide date of departure and provider’s role at the time (e.g., Resident, Fellow, R.N.).

Date of departure

Month

Day

Year

Cost Center Number *

FTE *

Start date

Month

Day

Year

Additional comments

Please include any additional information here.

Does the provider have any dietary restrictions?
Does the provider already have an ID Badge? If so, is it correct for their new position? Please contact the Badge Office for any badge-related questions (859-323-2356 or SecurityIDBadges@uky.edu).

Comment

Choose an orientation session

The schedule for orientation sessions is as follows:

Day 1: 8:15 am to 3:30 pm
Day 2: 8:30 am to 4:00 pm (classroom portion ends at 1:30 pm, with remaining time designated for online learning modules)
Day 3: varies based on specialty, details to be provided on day 1

Please select one of the following sessions.

The date selected must be on or after the new employee's start date.

July 11-13

July 18-20

July 25-27

August 1-3

August 8-10

August 15-17

August 22-24

August 29-31

September 6-8

September 19-21

October 3-5

October 17-19

November 7-9

November 21-23

December 5-7

December 19-21

UK HealthCare New Provider Orientation Registration

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