Get Kettering Health Network Otolaryngology Soin & Greene Delineation Of Privileges

Filling out the Kettering Health Network Otolaryngology Soin & Greene Delineation Of Privileges is a crucial step for applicants seeking core privileges in otolaryngology. This guide provides clear, step-by-step instructions to help you navigate the process with ease and confidence.

Follow the steps to successfully complete your application.

1. Click the ‘Get Form’ button to obtain the form and open it for editing.
2. Begin by entering the applicant's name in the designated field. Ensure accuracy to avoid any discrepancies.
3. Review the membership section to confirm eligibility requirements, focusing on education, training, and certification criteria.
4. Provide details of your clinical experience, specifying at least 50 otolaryngologic surgery procedures performed in the last 12 months. Alternatively, document successful completion of an accredited residency or clinical fellowship.
5. Outline your core privileges in otolaryngology by checking all applicable boxes. This includes detailed procedures like surgical interventions on the head and neck.
6. If you wish to request non-core privileges, list those separately, ensuring you meet all additional requirements for each.
7. Acknowledge your understanding of the privileges by reading the statement carefully and signing to confirm agreement.
8. Complete the 'Clinical Service Chief Recommendation' section, including any recommendations or conditions if applicable. Obtain the required signatures.
9. Finalize your form by reviewing all fields for completeness and accuracy. Make any necessary corrections.
10. Save your changes, download the completed form, print it for your records, or share it as required.

Complete your Kettering Health Network Otolaryngology Soin & Greene Delineation Of Privileges form online today.