Attachment_6_-_Credential_Review_Form.pdf
PDF 16 KB Posted
- Attached to
- Multidiscipline Healthcare Services
- Solicitation number
- HSCG23-17-R-P1C000
About this file
Attachment 6 - Credential Review Form
View the file
Other files
Show 40 more
Latest 50 of 51 listed here. See the rest on GovTribe.
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
HSCG23-17-R-P1C000 ATTACHMENT 6 Page 1 of 1
Credential Review
Contractor: _________________________ Position: _________________________ Candidate: _________________________ Location: _________________________
Section A:
General Medical Services YES NO
Current Curriculum Vitae Copies of Qualifying Educational Degrees: Diploma/Certificate Copies of State License(s) CPR Certification Evidence of Immunity Hepatitis A & B Copy of Social Security Card Proof of Current Competence (Letters of Recommendation) Proof of Continuing Education in the Past Two (2) Years
Section B:
Additional Physician Requirements YES NO
Copies of Post Graduate Training Certificates:
Internship Residency Board of Certification Copies of State License(s) DEA Certification
Comments:
Availability Date: ______________________________________________________________
Background Investigation attached:
File details come from the government source that posted it. Updated .