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[DOCX File]Sample Letter Re: Hospital Privileges and Competency ...
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All LIPs that provide care possess a current license, certification, or registration, as required by law and regulation The hospital, based on recommendations by the organized medical staff and approval by the governing body, establishes criteria that determine a practitioner’s ability to provide patient care, treatment, and services within ...
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[DOC File]APPLICATION FOR RESPIRATORY CARE PROFESSIONALS
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COMPOSITE STATE BOARD OF MEDICAL EXAMINERS. 2 PEACHTREE ST NW, 36TH FLOOR. ATLANTA, GA 30303. 404-463-2292. www.medicalboard.state.ga.us. I hereby make application for certification pursuant to the Georgia Respiratory Care Practice Act (O.C.G.A. 43-34-140) and submit the following statement concerning my age, moral character, education and practice.
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GEORGIA DEPARTMENT OF HUMAN RESOURCES
List the names of four references who can attest to your character, reputation, responsibility, integrity and competence. Have them communicate directly with the Committee using the Professional Reference Form provided. At least one of the references must be submitted by a Soil Classifier or person eligible for Certification familiar with your ...
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[DOC File]UHPCAF Part 1
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State Professional License(s) Federal Narcotics License (DEA Registration) Curriculum Vitae with complete professional history in chronological order (month & year) Diplomas and/or certificates of completion (e.g. medical school, internship, residency, fellowship, etc.)
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[DOCX File]ACKNOWLEDGEMENTS
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The nurse protocol legislation (O. C. G. A. § 43-34-23) enacted in 1989, authorizes Registered Professional Nurses (RNs) and Advanced Practice Registered Nurses (APRNs) who are agents or employees of a county board of health or the Georgia Department of Public Health (DPH) and who are adequately prepared, to perform certain delegated medical acts under the authority of nurse protocol.
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[DOC File]CCFA Enrollment Application Checklist - Georgia
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Proof of Professional license (licensed staff only) Copy of online verification from the Georgia Secretary of State required. Certified-Original transcripts (degreed, non-licensed staff only) Resume (non-degreed staff only) NOTE: Training requirements under review until further notice. Only submit existing training certificates when requested.
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[DOCX File]GEORGIA ASSOCIATION FOR NURSING EDUCATION, INC
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Verification of enrollment in an accredited nursing program. Validation of Georgia residency (photocopy of Georgia Driver's License) Verification of professional organization membership if applicable (photocopy of membership card) Two letters of recommendation.
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[DOC File]Part2
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Professional/Medical Specialty Information - Primary Specialty: ... Copy(ies) of W-9 for verification of each tax identification number used. Copy of workers compensation certificate of coverage, if applicable. ... 07/28/2003 Georgia Uniform Healthcare Practitioner Credentialing Application Form – …
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[DOCX File]DEPARTMENT OF COMMUNITY AFFAIRS
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Verification Requested. For. Adult Household Member: _____SS# _____DOB_____ The person identified above is applying for Shelter Plus Care Assistance. We are required by HUD to verify information provided by the family. The applicant has claimed that …
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[DOC File]Background Investigations
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May 31, 2004 · Education Verification (highest level) Professional License Verification. Certification & Designations Check . Professional Disciplinary Action Search. Department of Motor Vehicle Driving history. Consumer Credit Report. Newspaper Articles & Clippings. Bankruptcy and Federal District Court Search. Hiring/Rehiring Ineligible Persons.
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Professional license verification georgia