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
  • Download the required forms
• 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)

• 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