Transcription of Application For Medical Student Rotation
{{id}} {{{paragraph}}}
Example: quiz answers
Application For Medical Student Rotation
YAKIMA REGIONAL Medical & CARDIAC CTR 110 South Ninth Avenue Yakima, WA 98902 Medical Staff Services: (509) 575-5138 YAKIMA valley memorial hospital 2811 Tieton Drive Yakima, WA 98902 Medical Staff Services: (509) 575-8121 Application For Medical Student Rotation (This form must be completed in full with all attachments provided) NAME IN FULL: DATE: Any Other Name Used in Professional Practice: Medical School Name/Address: Contact Phone: Local Yakima Office Practice/Group Name: Residence Address: Residence Phone: DOB: SS#: e-mail address: Status Requested: Observational Active (must have a clinical education agreement on file with each hospital ) Rotation Start Date: End Date: Yes No Description Attach verification that this Rotation is an approved Rotation by your Medical school Attach verification that this Rotation is covered by professional liability insurance issued by the Medical scho
Yakima, WA 98902 Medical Staff Services: (509) 575-5138 YAKIMA VALLEY MEMORIAL HOSPITAL 2811 Tieton Drive Yakima, WA 98902 Medical Staff Services: (509) 575-8121 Application For Medical Student Rotation (This form must be completed in full with all attachments provided)
Loading..
Tags:
Information
Domain:
Source:
Link to this page:
Please notify us if you found a problem with this document: