UF PT Hire Request Form Please fill out the form below. Hire Request This form is for HR PT hire requests. Name of Requester* Position*FacultyAdjunct FacultyTEAMSOPS (Temporary)Student AssistantGraduate AssistantPost-doctoral AssociateOtherPosition Title Pay Rate **Pay rate should be shown as annual or hourly as applicable to the position title**Hours Per Week Candidate name(s) and email addresses:**If there are not enough spaces available, please email amelia05@phhp.ufl.edu with the candidate's name, UFID, and email address.**UFID (if applicable) Start Date* MM slash DD slash YYYY **Note: Start date is subject to employee meeting all health-related and/or background check requirements outlined by the job description**End Date MM slash DD slash YYYY Fund/Source(s)* **Please provide account information for entire fiscal year (June-July); must = 100%**Duties and Responsibilities*Will the employee have Patient Contact or contact with Bloodborne Pathogens?* Patient Contact Bloodborne Pathogens No Not Sure Employees having contact with patients or with human blood will require a health assessment and/or additional training. Please review the descriptions for Patient Contact and Contact with Human Blood and select any that are applicable below. Will this employee need an OCCMED assessment completed?* Yes No Is this a current UF employee?* Yes No