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Form Name:Malpractice Form
Completed By:Program Coordinator
Used When:Submitted yearly to request malpractice coverage for active residents at specific hospitals.
Purpose:


Excerpt
Combined with the Malpractice Spreadsheet, this form is submitted to the Vice Chancellor's Office to request verification of malpractice coverage for residents.


Direct Questions To:Cynthia Scott
Form Link:Malpractice Form 2015.pdf


Instructions for Completing Form for Active House Officers

Print the Malpractice Spreadsheet, attach to this form, and submit to the Vice Chancellor's office.


Instructions for Prior House Officers

        Requester should contact Cynthia Scott directly.

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