Stanford House Staff Address Update Form

Please provide confirmation of your address, so we can mail important human resource information such as benefits (i.e. medical cards) and payroll documentation to you. All information will remain confidential and will only be used for Stanford Healthcare HR-related purposes.

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* 1. What is your first name(s)?

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* 2. What is your last name(s)?

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* 3. What is your Date of Birth

Date

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* 4. What is your S-ID or 5 digit Employee ID (EEID)

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* 5. What is your street address? Example- 1850 Embarcadero Rd. Should be your local CA one.

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* 6. What is your city address? Example- Palo Alto

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* 7. What is your postal zip code? Example- 94303

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* 8. What is your mobile phone number?

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* 9. What is your personal email address?

*Indicates a required a question

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