California Dept. of Corrections – Full Credentialing Paperwork

Step 1: Complete our application process and CDCR documents.

Please click here to complete all of the following:

  • Application
  • GIS Background Form
  • Flu Declination form
  • HIPAA Form
  • Skills Checklist
  • 3 references (please forward to a minimum of 3 references and have them return email completed form to caleb.burke@genesishcc.com
  • TB test results within 12 months (send copy or use form attached to have TB completed) We can set up for you if needed
  • Hep B consent and declination
If you are applying for a pharmacist position, we will also need the CVUP packet completed by clicking Here
I-9 Process: Complete page 7 of the  I-9 click here and send us documentation from page 9 (must be received prior to starting work).

Note: “CareerStaff Rx utilizes the E-Verify program. Through this program, we will provide the Social Security Administration and Department of Homeland Security with information from each new employee’s I-9 form to confirm work authorization in the United States. Click Here for a document explaining the E-Verify program in more detail”

Step 2: Please fax the following to (610)612-3850 or email rxrecruiting@genesishcc.com

  • TB Test Results within 12 months (if you don’t have one, we can set up)
  • Copy of driver’s license and social security card
  • Copy of Resume
  • Copy of pharmacy license (non-online version)

 

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