Get Az Banner Health Banner Baywood Medical Center Anesthesia Privilege Checklist - Mesa_dsa

This guide is designed to assist users in accurately completing the AZ Banner Health Banner Baywood Medical Center Anesthesia Privilege Checklist - Mesa_DSA form online. Following these detailed steps will ensure that all necessary information is provided correctly.

Follow the steps to fill out the anesthesia privilege checklist online.

1. Click the ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin by entering your name in the 'Physician Name' field located at the top of the form. Ensure that your name is spelled correctly, as it will be part of your official records.
3. Review the section titled 'Anesthesia Core Privileges.' Familiarize yourself with the list of privileges. Ensure you are prepared to confirm your understanding and agreement with these procedures before announcing your capabilities.
4. For any special procedure privileges, indicate your qualifications by checking the appropriate boxes, such as invasive pain management privileges. If applicable, provide any required documentation to support your claims of specialty certification or training.
5. Acknowledge that you have read and understood the updated rules and regulations of the Department of Anesthesia by signing and dating the indicated line.
6. Leave space for the privileges approved section. This section will typically be filled out by the committee chairman, so ensure that it is left blank for their use.
7. Once you have completed all sections of the form, save your changes. You may then choose to download a copy of the form, print it out, or share it as required.

Complete your documents online efficiently and accurately today!