Requirements for Medical Staff Appointment

By-Laws for Medical Staff Privileges

View the entire set of Medical Staff By-Laws.

´╗┐Medical Staff Office Requirements

  • Current Infection Control Certificate - Register Online - Due every 4 years
  • Malpractice Face Sheet – Due annually (See your office manager for information.)

Department of Pediatrics Requirements

  • Mandatory In-Service - View Instructions - Completed annually
  • Respirator Mask Fit
    • Appointments are set up through Occupational Medicine office
    • Not needed if choosing Refer/Follow Privileges
    • Download the required forms
  • HIPAA - Completed when you first apply for Privileges
    • View the manual and download the sign-off form.
    • Fax to Tracy June upon completion.
  • Pain Attestation - Completed when you first apply for Privileges

Contact Us

Office of the Administrative Director of Clinical Services for Golisano Children’s Hospital
Tracy June
Phone: (585) 275-1846
Fax: (585) 276-0403

Contact Us

Medical Staff Office
Phone: (585) 784-8822
Fax: (585) 784-8367