Get Mi Certification Of Appointment To A Training Program For An Osteopathic Physician License 2016

The MI Certification Of Appointment To A Training Program For An Osteopathic Physician License is an essential document for those seeking to complete their training in osteopathic medicine in Michigan. This guide provides a thorough overview of how to fill out the form online, ensuring that you understand each part of the document.

Follow the steps to accurately complete the form.

1. Press the ‘Get Form’ button to acquire the MI Certification Of Appointment To A Training Program For An Osteopathic Physician License and open it in your online editor.
2. In the section listed for the applicant’s information, provide the following details: first, middle, and last name; date of birth; address including city, state, and zip code; telephone number; and email address.
3. Next, the remainder of the form must be completed by the medical director or superintendent of the training hospital. They should include the name and address of the hospital or institution, specifying city, state, and zip code.
4. In the certification and signature section, the medical director or superintendent must affirm the appointment of the applicant by filling in their position in the training program, specifying whether it’s an internship or residency, along with the name of the program and the start date.
5. Answer the questions regarding the approval of the training program by AOA and ACGME by selecting 'Yes' or 'No' as applicable.
6. The medical director or superintendent should then sign and date the form, including their printed or typed name. If the academic institution does not have a seal, this must also be noted in the space provided.
7. Once all fields are completed, review the form thoroughly for accuracy. You can then save your changes, download, print, or share the form accordingly.

Ensure your application is processed smoothly by completing and submitting the MI Certification Of Appointment To A Training Program For An Osteopathic Physician License online today.