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Find A Doc Data Sheet Form for Community Providers

The following document is provided for providers at Upstate University Hospital's Community Campus who are not employees to be included in the Find A Doctor system.

This file must be downloaded to your local computer and then printed or completed using Adobe Acrobat reader, then returned to the Medical Staff Services office at Upstate Medical University.

  1. Please click on the link below to download the form.
  2. Note the location that the form is being saved to on your computer.
  3. Navigate to that location and complete the form.
  4. When complete, please return the form to medstaff@upstate.edu.
  5. If mailing, please send form to
    Upstate Medical University
    750 East Adams Street
    Syracuse, NY 13210
    ATTN: Medical Staff Services

Find A Doc Data Sheet Form for Community Providers This is a PDF FIle


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