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Completing the New Hire Process
Pre-Placement Exams
Prior to your first day of orientation, you must complete a pre-placement medical exam at Occupational Health. If you DO NOT have an appointment, call NOW to schedule:
Southside: 261-6752
Peninsula: 827-2153
Williamsburg: 984-7438
Suffolk: 934-4523
 Please bring with you to this appointment:
Download the following forms. You can complete electronically and print or print and fill out. Please DO NOT sign forms until you arrive for your screening appointment.
Form Technical Details:
 You must have Adobe Reader to use these forms. Adobe Reader is free software that lets users view, fill and print filled in Adobe PDF files on all major computer platforms. Some of the forms are provided as "fillable" PDF files for your convenience. You must have at least Adobe Acrobat Reader 4.0 installed on your computer to view, complete and print fillable forms.
For "Fillable" PDF files: Acrobat Reader does not allow you to save what you key into the form, nor can you email the completed form - you should plan on completing and immediately printing completed forms. For some people, it may be easier to print and complete all of the forms by hand. You may do what works best for you.
Form 1: Criminal History form for Virginia (and Out-of-State form, if applicable)
- Detailed instructions for filling out Criminal History forms (PDF file)
- Virginia Criminal History form (Fillable PDF file)
- Out-of-State Criminal History form (Fillable PDF file)
Instructions: Open form in Adobe Reader (by clicking on it), type in details within reader, print and bring to orientation. If you have ever lived outside the state of Virginia, please fill out the "Out of State" form in addition to the Virginia form. Note: this form will be notorized at the time of your pre-placement medical exam. Do not sign it until that time.
All new hire candidates are asked to give permission for Sentara Healthcare to request a criminal background check.
Sentara will pay for this record request - you do not need to pay.
Be sure to print the PDF of the Directions for filling out these forms, as they can appear complicated and the directions will assist with specific details.
Form Details: Authorizes Sentara to do a criminal background check on potential employees.
- To be completed by all new hire candidates.
- Answer all questions to the best of your ability.
- Your medical history will be reviewed with the Occupational Health nurse.
- To be completed by new hire candidates who will be required to wear a respirator during the performance of their job. (e.g., nursing and other clinical staff who will have contact with patients, laboratory staff, facilities maintenanc staff, etc.)
- This includes N-95 respirators for protection against TB, and other air purifying respirators such as full or half-face respirators as appropriate.
- Complete all requested information
- Answer health questions by checking the appropriate "Yes" or "No" column.
- To be completed only by new hire candidates who will be required to wear disposable gloves during the performance of their jobs.
- Complete all questions
You should also bring:1. Immunization records to include MMR (Measles, Mumps, Rubella), Hepatitis B, Varicella (Chickenpox) and Tetanus OR laboratory results of immune titers for Measles, Mumps, Rubella, Varicella (this information may be obtained from your physician or previous health care employer).
2. List of any prescription/non-prescription medications which you are currently taking.
3. Documentation of your last TB skin test or chest x-ray report. This information may be obtained from your physician or previous health care employer.
4. If you have had a positive TB skin test in the past, bring your records related to treatment with INH from your personal physician or the public health department where you received treatment.
5. Picture ID (Acceptable picture identification will be the same as indicated on the back of the I-9 form and cannot be expired).
Please allow at least an hour to complete your health screen.
To ensure their safety, Please DO NOT bring small children to your appointment.
Please arrive at least 15 minutes prior to the time that has been scheduled for your appointment.
You will complete a medical history, receive an assessment to determine your ability to do your new job, receive information about the Hepatitis B vaccine if required, receive a tuberculosis skin test if needed and receive other tests as required by the job offered.
You will also be required to complete a pre-employment drug test.
Please DO NOT call the lab or Occupational Health about the drug screen results.
If your drug screen is positive, a representative will contact you.
If you are found to be ineligible for hire due to drug test results, you will be informed prior to your start date and you will be required to wait a minimum of 1 year before being considered for employment within Sentara.
For your safety and the safety of our patients, all new hires are required to complete a criminal record release form allowing Sentara Healthcare to access your criminal record history.
Please bring the completed form(s) to your appointment with Occupational Health where the document(s) will be notarized.
Convictions listed on the criminal record disclosed on your Sentara Healthcare Application for Employment, may be grounds for withdrawal of your employment offer or termination of employment.
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