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Clinica New Starter Form Naimah Tikly

The document is a New Starter Form for Clinica London, requesting personal, emergency contact, medical, payroll, and reference information from new employees. It emphasizes the confidentiality of the information provided and outlines the pension contribution scheme available after one month of service. Employees are required to authorize reference checks from previous employers as part of the onboarding process.

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mimi12345stoycheva
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17 views5 pages

Clinica New Starter Form Naimah Tikly

The document is a New Starter Form for Clinica London, requesting personal, emergency contact, medical, payroll, and reference information from new employees. It emphasizes the confidentiality of the information provided and outlines the pension contribution scheme available after one month of service. Employees are required to authorize reference checks from previous employers as part of the onboarding process.

Uploaded by

mimi12345stoycheva
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Strictly Private and Confidential

New Starter Form

Welcome to Clinica London

Please note that the following information will be treated confidentially and is requested as
part of our commitment to ensuring correct and up to date HR files. Some of this information
may be shared with our Payroll Bureau or those stated throughout. Please do contact us,
should you have any objections to this.

Personal Details
Full Name:

Date of Birth:

Address:

Telephone No:

Personal Email:

Emergency Contact
Please provide details of the person you would want us to contact in an emergency.
Full
Name:

Relationship: (e.g. spouse, partner,


friend)
Address:

Contact telephone No:


Medical Information
So that we can protect your health and safety and also consider any potential reasonable
adjustments that it may be appropriate for us to make in line with provisions under the
Equality Act 2010, please provide details below of any medical conditions (e.g. diabetes,
epilepsy), allergies, or disabilities. Please note that this information will be treated with
confidence, but may be shared with your Line Manager unless you state otherwise.

Food/allergies/catering requirements
Payroll Details:
National insurance

Bank Name:

Bank branch address:

Name of account holder:

Sort Code:

Account number:

Pension Contributions:

After you have completed one month's continuous service, you will be eligible to join Clinica
London’s pension scheme. Clinica London will make employer pension contributions of 3%
and the employee can contribute the percentage of their choice, subject to a minimum
employee contribution of 3%.

Please indicate your contribution below:

I wish to contribute the percentage below per month (3% minimum):


3%

Human Resources will give you more about this scheme at the Induction.
Referee details:

Please provide details of your last two employers.

Please note HR contacts for each employer.

Consent:

I hereby authorize you to take up references from my previous employer(s) and/or my


present employer (once the offer of employment has been confirmed in writing) and my
past employer. This may include confirming my Date of Birth, NI number and others.
identifying information by email. In addition, I hereby authorize you to take up other
reference checks as you may deem appropriate.

Employee's signature

Date:

1st Reference

Company:

Start and end date of


employment:

Name of HR contact
and job title:

Email of contact:

Phone number of contact:

Your job title whilst


employed:

2nd Reference

Company:

Start and end date of


employment:
Name of HR contact
and job title:

Email of contact:

Phone number of contact:

Your job title whilst


employed:

END

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