Fall/Winter Go Lives – Chicagoland Fall/Winter Go Lives - Chicagoland Please use the following form to submit your availability for our go live starting 12/1/18 in Chicagoland. There will also be an opportunity for pre go live work starting in October detailed in this form. Name* Preferred Email*Please provide your preferred email regarding this project. It's okay if this is different than your sign up email. Is this a revised form?* No, this is my first form submitted for this project Yes, this form is a revision of a previously submitted form Have you worked an MDL Go Live in the past* No Yes Level* M1-2 M3 M4 Resident Physician Physician NP/PA Consultant/Other School or Residency program*Where are you currently using Epic (residency program or med school, or other) Weeks Available*Please check weeks you're available. If there are specific days off you need please advise in notes to availability below. Available for entire project 12/1/18 - 1/11/19 Week 1: Saturday 12/1/18 - 12/7/18 Week 2: Saturday 12/8/18 - 12/14/18 Week 3: Saturday 12/15/18 - 12/21/18 Week 4: Saturday 12/22/18 - 12/28/18 Week 5: Saturday 12/29/18 - 1/4/19 Week 6: Saturday 1/5/19 - 1/11/19 Weekends off?*Accommodating weekend off requests will not be a problem and will not effect your likelihood of being staffed on the project. Please let us know below if you'd like some or all weekends off: Yes - I'd like some or all weekends off No - I'd prefer to work weekends Impartial Notes to availabilityIf applicable, please provide any notes to availability listed above.Are you interested in and available for additional pre go live work starting 10/1/18?*There are pre go live opportunities for 10/1 - 11/20 and 11/21 - 11/30. The pre go live work will be M-F only. If interested in either or both of these periods please click yes. Yes No If available for pre go live work, are you comfortable with BEACON?*This is not a requirement of pre go live work, however, there are more opportunities if you're comfortable with BEACON. Yes No Epic ExperienceIf you'd like, please provide a brief description of your Epic experience.File Upload If NecessaryIf you'd like to upload any files, please do so here. Drop files here or Select files Max. file size: 32 MB.