you have a Medical Director change, please
complete the following four (4) steps.
Provide an electronic/scanned copy of the institution's Letter of Appointment and Acceptance.
This letter must contain the following four (4) items:
Signed by the President/CEO
The effective (start)
Signed by the individual accepting
Provide an electronic/scanned copy of the Medical Director's CV showing:
formal education, professional licenses/board certifications, and related
Complete the "Personnel
the completed Personnel Change form and the two (2) electronic documents to: email@example.com