Credentialed Provider Orientation Attestation

Attestation

Name:

Email Address:

Attestation:
Yes, I have reviewed the information and videos provided online for Credentialed Provider Orientation. I agree to abide to all hospital policies and Medical Staff Bylaws, and understand that I can access these online, or request them from Medical Staff Services. By submitting this form I attest to reviewing all of the included education requirements. I acknowledge that I have reviewed the video and materials relevant to the Code of Professional Behavior, and will be held to these standards. I understand that this attestation will be kept in my credentialing file for future reference.

Please verify you are human!