Access to SCCA
If you require access to an SCCA Building only or the building and SCCA’s network, but not to patient information (PHI), the Non-Employee Staff Paperwork Packet needs to be reviewed and completed in its entirety.
Please have all paperwork submitted at least two weeks prior to your start date.
Schedule a time to meet with the Human Resource Department in the FHCRC Yale Building to complete your required SCCA non-employee paperwork at:
Human Resource Administration,
823 Yale Avenue N, MS: J1-105
Non-Employee Staff Paperwork includes:
- HR Non-Employee Action Form (PDF):
- This form must be filled out by your direct Supervisor and signed by your SCCA Manager or an approved SCCA Sponsor. Please refer to the approved sponsor list (PDF) for more information on who should sign your form.
- If you will require network access (O:/J:/H:/ Drives) and/or email access to perform your job duties be sure to check those items under the heading “Please check any required SCCA items for this non-employee“. If you will not be using the SCCA network please do not select any boxes related to network account or email activation.
- SCCA Confidentiality Policy Agreement
- Photo ID
- Key Card (only if required to perform your job duties)
- Criminal History Information Form
- Disclosure and Authorization to Obtain Information
- Immunization Health History
- Harassment in the Workplace
- Review and attestation of the Integrity at Work booklet
- Review of Patient Rights and Responsibilities
- Information Packet Forms Agreement
- Self Guided Orientation Packet
For questions or concerns about SCCA’s Non-Employee Affiliate process please contact the privacy office at 288-6266 or email@example.com.
For questions about affiliate paperwork, timelines, and status contact the Human Resource Department at 667-4700 or firstname.lastname@example.org.
Non-Employee Action Form
SCCA Final Sponser List