Get Mi Certification Of Appointment To A Training Program For An Osteopathic Physician License 2020-2025

Completing the MI Certification Of Appointment To A Training Program For An Osteopathic Physician License is a crucial step for individuals involved in osteopathic medical training in Michigan. This guide will provide you with clear, step-by-step instructions on how to accurately fill out the required online form and ensure a successful submission.

Follow the steps to complete your certification form with ease.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the applicant information. Fill in the applicant’s first name, middle name, last name, address, city, state, date of birth in MM/DD/YYYY format, zip code, email address, and telephone number.
3. The next section must be completed by the medical director or superintendent of the training hospital. Provide the name of the hospital or institution, its address including state, city, and zip code.
4. If applicable, enter the AOA or ACGME program approval number.
5. In the certification and signature section, the medical director or superintendent must certify that the applicant has been appointed to a training program by filling in the program name, start date, and end date.
6. The medical director or superintendent must then sign the form, print or type their name, and date the form.
7. Finally, if the academic institution does not have a seal, indicate this in the relevant area.
8. Once all fields have been filled, you can save changes, download, print, or share the completed form as needed.

Take the next step in your medical training journey by filling out the certification form online today.