Get Etsu Health Employee Badge Request Form

Completing the ETSU Health Employee Badge Request Form online is a straightforward process designed to facilitate the issuance of employee badges. This guide provides clear, step-by-step instructions to help users accurately fill out the required information and submit the form efficiently.

Follow the steps to complete your online badge request form

1. Click ‘Get Form’ button to access the badge request form and open it in the document editor.
2. Fill in your first name and last name in the designated fields. Ensure that the names match your official identification.
3. Enter your employee number (E#) in the appropriate field. This number is unique to you within the ETSU Health system and is necessary for processing your request.
4. Provide your email address. It is important to use a valid email that you check regularly for communication regarding your badge.
5. Select your degree or credentials from the dropdown list. This section includes various professional qualifications that may apply to your role.
6. Indicate your license type or role by choosing one option from the provided categories. Ensure your selection correctly represents your position within ETSU Health.
7. Identify your primary clinical practice site by selecting one from the list given. This information assists in determining your work location.
8. Complete the payment and delivery information section. Indicate whether the badge is being charged to your department or if you will be paying for it personally.
9. If the badge is a replacement, indicate 'Yes' or 'No' in the appropriate field. Make sure to fill in the department account code if applicable.
10. Specify your preferred delivery method, either for pick-up or through a campus box. If you select campus box, be sure to provide the correct box number.
11. Obtain your supervisor's approval by having them fill in their name, title, department, and phone number. Their signature is required to finalize the request.
12. Double-check all entries for accuracy. Once confirmed, you can save the changes, download, print, or share the completed form according to your needs.

Complete your ETSU Health Employee Badge Request Form online today to ensure your badge is processed efficiently.