Malpractice Form

Malpractice Form

Form Name:

Malpractice Form

Completed By:

Program Coordinator

Used When:

Submitted yearly to request malpractice coverage for active residents at specific hospitals.

Purpose:

 

Direct Questions To:

Cynthia Scott

Form Link:

Instructions for Completing Form for Active House Officers

Print the Malpractice Spreadsheet, attach to this form, and submit to the GME office for GME signature. Once processed in GME, it will be sent to the Vice Chancellor's office.  When filling out the Malpractice Form, only 1 copy of the form needs to be filled out and submitted.  Under the "Name" and "Title" fields in the form, put "See Attached" as the spreadsheet will have all of the needed information for each resident.

 

Instructions for Prior House Officers

        Requester should contact Cynthia Scott directly.

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