Forms and Links
Genetic Information Nondiscrimination Act
This notice contains instructions for preventing disclosures of genetic information that are prohibited under the Genetic Information and Nondiscrimination Act of 2008.
Health Record Form
This form must be completed prior to your first Occupational Health visit. You will also need to bring a copy of your vaccination record to the visit.
Immunizations Required by Occupational Health Services
This sheet lists all the immunizations that Occupational Health Services requires for its employees. Please note the mandatory influenza policy and process for documenting contraindications.
New Employee Medical Record Request Form
This form allows a new employee to request that their available medical records be sent directly to Occupational Health Services for review.
Fax Cover Sheet
Please identify yourself using this fax cover sheet when you are sending any of your pre-hire paperwork to Occupational Health Services.
Criminal Offender Record Information (CORI) Acknowledgement Form
Consumer Report/Investigative Consumer Report Disclosure & Release of Information Authorization
Education and Employment Verification Form
All employees must authorize the Institute to conduct a criminal background check as a condition of employment. These forms must be completed prior to attending orientation.
This form must be completed by all employees receiving a paycheck from Dana-Farber. Please complete the top half and bring to Human Resources with proper identification. A list of accepted identification can be found on the form.
Foreign National Tax Form
This form must be completed by all employees of Dana-Farber Cancer Institute who are working on a visa.
Applying for a Social Security Number
The Internal Revenue Service (IRS) requires that all employees of Dana-Farber Cancer Institute who are working on a visa obtain a Social Security Number in order to receive tax treaty benefits. This form will explain how to obtain a social security number.
If you are not a citizen or permanent resident of the United States, you must obtain a visa to work at Dana-Farber. The applications below will help you to get started.
If you have any questions about the forms listed above, please contact Human Resources at 617-632-3052. It is important that all paperwork be completed prior to your Occupational Health visit.