This category of appointment is primarily for private practitioners who make significant contributions to the clinical teaching programs of the Division of Biological Sciences. Typically, physicians in this category volunteer their time to the University on a part-time (benefits ineligible) basis and provide their services either at the University or one of its affiliated or associated hospitals. Appointment to this category is frequently contingent upon achievement and maintenance of attending privileges at The University of Chicago Hospitals or an affiliated or associated hospital. Normally, the initial term of appointment is made for five years.

In some instances, unpaid appointments may need to be reviewed for determination of Medicare reassignment compliance. These appointments require a separate checklist. MS Word

Appointment proposal--The department will prepare and submit a recommendation for the appointment that is reviewed by OAA for completeness, endorsed by the Dean and submitted to the Provost’s office for approval. An original recommendation should be submitted to OAA. A complete recommendation will include:

_____ New appointment checklist (if compensated) MS Word

Chairman’s letter to Dean which should include

• name of candidate
• proposed academic rank, track, effective date, term (normally, term end date is June 30 except for individuals on the Research Associate track)
• % effort
• proposed compensation and mix
• statement of the individual's clinical activity and reputation, as well as role envisioned
• statement of the individual's teaching activity and reputation, as well as role envisioned

_____Updated CV MS Word

_____ Sample solicitation letter

_____ Referee grid

_____ Letters of evaluation from external referees

Post-approval/Payroll—Upon approval of appointment and attending privileges, the department should process a Multiple Action Form (MAF) with appropriate attachments to get the new recruit into the University’s payroll system. Forms must be received by the OAA payroll deadline to guarantee a paycheck at the end of the month. payroll deadlines

If this is an unpaid appointment, only the MAF and Compliance screening need to be submitted to OAA.

MAF—Not available on-line. Please contact OAA for a supply of blank forms.

_____     I-9 form and attachments ADOBE PDF

_____     UPP192 and attachments (for Permanent Residents and Non-Immigrant Aliens) ADOBE PDF

_____     Federal W-4 tax form ADOBE PDF

_____ State W-4 tax form ADOBE PDF

______ Compliance Screening form with original signatures and within the last 30 days w/ results Cover Sheet and Screening Form