EXITING EMPLOYEE CHECKLIST Use this form to document that all procedures were followed when an employee leaves the practice Practice Name:*Employee Name (full name)*Position:*Last date of work:* MM slash DD slash YYYY Date of termination procedures completed:* MM slash DD slash YYYY Type of Termination*VoluntaryInvoluntaryComputer and network Access:* Select All N/A EMR account disabled Practice Management account disabled Windows domain account disabled Email disabled VPN disabled Payor online accounts disabled or passwords changed Change phone extension Change voicemail Office Access:* Alarm code changed Collect the following Items by Last Day of Work:* Done N/A Items collected:* Office Keys; building, file cabinets, desk Business cards Name badge Company Credit Cards Cellphone Pager Laptop Tablet Uniforms Others:*
