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14. The employee is responsible for obtaining the signatures from all applicable receiving departments. DEFINITIONS None SUMMARY OF CHANGES Replaces document of the same title, effective 9/07 RESOURCES/TRAINING Resource/Dept Administration Human Resources Representative Internet/Link DOCUMENT APPROVAL & TRACKING Item Contact Date Approval Owner Clinical Operations Director Lori Anderson, HR Representative Stanton Royce, Compliance Officer Consultant(s) Beth Freshman, Supervisor, Clinical Administrative Support Sandi Peacock, Nurse Manager Committee(s) UNM Cancer Center Policy, Procedure and Guideline Committee UNM Cancer Center Clinical Operations Group Nursing Director Sandi Peacock, RN, MBA, Nurse Manager Y Medical Director Ian Rabinowitz, MD, Clinic Medical Director Y Human Resources Lori Anderson, HR Representative Y Finance [Name, Title], [UNMH or HSC] [Y or N/A] Legal [Name, Title], [UNMH or HSC] [Y or N/A] Official Approver Don Whitehead, Chief Operations Officer and Clinic Administrator Y Official Signature Effective Date 12/22/08 Origination Date 9/21/07 Issue Date Clinical Operations P&P Coordinator ATTACHMENTS Separation Check-Off List for Staff Employees Y Title: Employee Separation Checklist Owner: Clinical Operations Director Effective Date: 12/22/08 SEPARATION CHECK-OFF LIST FOR STAFF EMPLOYEES Last Revised: 11/26/08 Page 2 of 4
NAME_________________________________________________BANNER ID #__________________ DEPARTMENT________________________________DEPARTMENT PHONE________________________________ FORWARDING MAILING ADDRESS:____________________________________________________________________________ HOME PHONE (______)_____________________ 1.*Manager: Submit UNM Staff Employee Separation Form to Human Resources Has employee turned in the following items to you? If applicable: Cell phone____Pager____ Calling Card____ Computer Applications ____ Please request deactivation of calling card, long distance authorization code, cell phone and/or pager and remove the individual's access to voicemail. This can be accomplished by contacting Telecommunications at telecom@unm.edu. 2. Purchasing or Health Sciences Controller's Office (if applicable) Sign here: Turn in: A. Purchasing Card _______ 3. Property Accounting-Turn in University equipment Sign here: (if applicable) 4..Risk Management Department (if applicable) A. Turn in radiation badge ____ Sign here: B. +Close out procedure for chemical/biological agents ____ 5. Parking Services-Parking Permits (required) Sign here: 6. General Library or Health Sciences Library for Sign here: HSC employees-Circulation Desk (required) 7.**Physical Plant Lock Shop-Turn in keys (required) Sign here: 8. Bursar's Office (required) Sign here: 9. University Department of Human Resources (required): A. Obtain Insurance Benefits Information____ Sign here: B. ++Complete Exit Interview____ C. Return UNM ID - Benefits Office____ D. Complete Retirement Reimbursement Form____ 10. Return Completed Check-Off List Sign here: AUTHORIZED SIGNATURE Employee's Supervisor Health Sciences Center employees must return this form to the University Health Sciences Department of Human Resources after completion. All other employees must return the form to the University Payroll Department. • *The UNM Employee Separation form and this Check-Off List should be started at least ten (10) working days in advance of the separation date or as soon as the department becomes aware that an employee is separating. The manager may sign-off indicating N/A for those areas that are not applicable. If the area indicates the signature is required, the employee must obtain the required signatures. Title: Employee Separation Checklist Owner: Clinical Operations Director Effective Date: 12/22/08 Page 3 of 4
Page 1: Applies To: UNM Cancer Center Compo

Page 1 of 4 DESCRIPTION/OVERVIEW This procedure describes ...

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