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- Witness to Witness (W2W)
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Appeal and Hearing Process
Sample written policy for clinician appeals and hearings related to privileging and appointment.
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- 74 appealandhearingprocess ( 191 Kb )
Application for Clinical Privileges Allied Health Professional Specialty: Family Nurse Practitioner (FNP)
Application for Clinical Privileges Allied Health Professional Specialty: Family Nurse Practitioner (FNP)
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- AHP - Family Nurse Practitioner ( 76 Kb )
Application for Clinical Privileges Physician Specialty: Dentistry
Application for Clinical Privileges Physician Specialty: Dentistry
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- Physician - Dentistry ( 63 Kb )
Application for Clinical Privileges Physician Specialty: Family Medicine
Application for Clinical Privileges
Physician
Specialty: Family Medicine
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- Physician - Family Medicine ( 71 Kb )
Appointment Process Flow Chart
This document outlines the process a health center goes through to appoint a new clinician to staff.
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- 42 ClinicalHiringFlowChart ( 203 Kb )
Appointment, Credentialing, & Privileging Guidelines
Comprehensive Health Center guidelines for privileging, credentialing and appointments.
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- AppointCredenGuidelines ( 95 Kb )
Clinical Assistant Privileging Request Form for General Care
Clinical Assistant privileging request form related to nursing abilities, patient well-being, and IVs.
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Clinical Assistant Privileging Request Form for Lab Procedures
Clinical Assistant privileging request form for lab procedures related to In-House Lab Tests and Microscope Use.
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Clinical Privileges Request Form- Family Practice Primary Care Providers
Clinical privileging defines the scope and limits of practice for individual providers. Privileges are based on evaluation of the individual’s credentials and performance. Information on this form may be released to professional organizations if needed to license or monitor professional standards of health care providers.
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