Forms

Program Updates or Changes

• Participating Site Change Request
• Complement Request Funding Form
  • ACGME – Requests for Changes in Resident Complement
• Adding New Personnel or Changing Privileges in New Innovations
• MD Anderson Rotation Request – UT Residents going to MDA
• TMB Program Director’s Report
• Contract Exception Request Form

New Programs

• Program Letter of Agreement Template (PLA)
• Application Process for New Training Programs
• Application For Board-Approved Fellowship

Away Electives & Visiting Residents

• Application for Away Elective Rotation
• Pre-Registration for Visiting Resident
• Out of State Visitor – Sample Program Director Letter to TMB

Interviews & Onboarding

• Demographic Sheet for Interview Applicants
• IMG Document Review Worksheet for Coordinators
• IMG Document Review Worksheet for Applicants
• Resident White Coat Order Form
• Resident Parking Packet
• Resident Sample Agreement

Graduates

• UT GME Resident Checkout Form
• HCHD Checkout Form

Program Tools & Resources

• Moonlighting Request
• Improvement Plan Table
• Template Individual Learning Plan
• UTHealth PEC Minutes Form

 Resident & Fellows

• Anonymous Report of Resident Concerns & Duty Hour Violations
• Reporting an Injury (Safety, Health, Environment, and Risk Management)
• GME Fatigued Resident Travel Reimbursement Form (NOTE: You must also submit a completed and signed Self Attestation Form

Leave Requests

• GME Leave Request
• Family Medical Leave Forms