Requirements for Medical Staff Appointment
Requirements for Medical Staff Appointment
By-Laws for Medical Staff Privileges
View the entire set of Medical Staff By-Laws. (May require sign-in.)
Medical Staff Office Requirements
- Health Assessment - Due annually
- PPD - Due annually
- Download the required forms
Appointments are made by contacting:
Occupational Medicine Office
Calkins Corporate Park
400 Redcreek Dr., Suite 22
Phone: (585) 487-1000 (Option #2)
- Download the required forms
- 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 HIPAA manual and download the HIPAA sign-off form.
- Fax to Piera Inglese upon completion.
- Pain Attestation - Completed when you first apply for Privileges
- View the Pain Attestation manual and download the Pain Attestation sign-off form.
- Fax to Piera Inglese upon completion.
Contact Us
Piera Inglese
Phone: (585) 273-1720
Fax: (585) 273-1079
Piera_Inglese@urmc.rochester.edu