Conformed__Atch 7 Key Personnel Checklist.pdf
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List of Proposed Key Personnel Checklist
Requirement Check
(Yes) (No)
Copy of Curriculum Vitae (CV)
Copy of Advance Cardiac Life Support/Basic Life Support (ACLS/BLS) Certifications
Board Certification / Board Eligibility
Proof of Health Tests / Immunizations:
TB
Measles
Mumps
Rubella
Varicella
Inf luenza
Evidence of Blood-Borne Pathogen Training
National Provider Identifier
DEA Certificate
Rules of Behavior Appendix D
License to Practice Medicine
VSC Security Documents Do Not Provide with Of fer
Do Not Provide with Of fer
Conformed to RFP Amendment 0003 - page revised by Amend. 0001.
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