Get the free Moonlighting Request Routing Form - Graduate Medical Education

Internal Moonlighting Request Form For residents and fellows (hereinafter referred to as ?residents?) PART I: To be completed by requestor: (Requestor is individual who wants to utilize resident’s

How to fill out moonlighting request routing form

1. To fill out the moonlighting request routing form, start by obtaining the form from your employer or the appropriate department within your organization.
2. Carefully review the form and any accompanying instructions to understand the required information and documentation.
3. Begin by providing your personal details such as your full name, employee ID, department, and job title.
4. Indicate the specific dates or period for which you intend to engage in moonlighting or secondary employment.
5. Specify the nature of the secondary employment or moonlighting activity, including the company or organization name, location, and type of work you will be involved in.
6. Disclose any potential conflicts of interest that may arise between your primary job and the secondary employment, along with any steps you plan to take to manage or mitigate these conflicts.
7. If required, attach any supporting documentation as requested, such as a letter of agreement or contract from the secondary employer.
8. Sign and date the form to certify the accuracy of the information provided.
9. Submit the completed form to the designated person or department responsible for processing moonlighting requests.

Who needs the moonlighting request routing form?

1. Employees who wish to engage in secondary employment or moonlighting in addition to their primary job.
2. Individuals who have specific policies or regulations in their organization that require them to disclose and seek approval for any secondary employment.
3. Employees who want to ensure transparency and minimize conflicts of interest between their primary job and secondary employment.

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What is moonlighting request routing form?

The moonlighting request routing form is a document used to request approval for employees to engage in additional employment outside their primary job.

Who is required to file moonlighting request routing form?

Employees who wish to work in a secondary job or moonlight while still employed at their primary job are required to file this form.

How to fill out moonlighting request routing form?

To fill out the form, employees should provide their personal information, details of the secondary employment, and any potential conflicts of interest, followed by submission to their supervisor or HR department for approval.

What is the purpose of moonlighting request routing form?

The purpose of the moonlighting request routing form is to ensure that any additional employment does not conflict with the employee's primary job responsibilities and to maintain transparency within the organization.

What information must be reported on moonlighting request routing form?

The form typically requires the employee's name, job title, the nature of the secondary job, hours of work, and confirmation that the additional employment does not interfere with their primary job duties.