APPENDIX C VERIFICATIONS PERFORMED AT INITIAL APPOINTMENT AND REAPPOINTMENT
Initial Appointment Accredited Medical / Dental / Podiatric Education
Primary source verified by, but not necessarily limited to, AMA / AOA profiles, FSMB, National Student Clearinghouse, or directly through the school
Reappointment
Internship, Residency, Fellowship
Primary source verified by, but not necessarily limited to AMA / AOA profiles, FSMB, or the specific training program
Hospital / Medical |
Staff |
Affiliations |
post- |
Residency |
|
|
|
Directly with the facility
Professional State License
Primary source verified with state licensing board( s), FSMB or AMA profile
• Also verified when requesting new privilege mid-cycle or time of expiration
Hospital / Medical Staff Affiliations since last appointment at Renown
Directly with the facility
Professional State License
Primary source verified with state licensing board( s), FSMB or AMA profile
• Also verified when requesting new privilege mid-cycle or time of expiration
Professional State License Sanctions
Primary source verified with state licensing board( s), FSMB, AMA profile or NPDB
• Also verified when requesting new privilege mid-cycle or time of expiration
Professional State License Sanctions
Primary source verified with state licensing board( s), FSMB, AMA profile or NPDB
• Also verified when requesting new privilege mid-cycle or time of expiration
Drug Enforcement Agency
Primary source verified through the Drug Enforcement Agency, NTIS, FSMB, or AMA / AOA profile
• Also verified when requesting new privilege( when a DEA may be required) mid-cycle or at time of expiration
Drug Enforcement Agency
Primary source verified through the Drug Enforcement Agency, NTIS, FSMB, or AMA / AOA profile
• Also verified when requesting new privilege mid-cycle or time of expiration
Nevada State Pharmacy Primary source verification through the Nevada State Board of Pharmacy Professional Peer References List three professional peer references knowledgeable about the applicant’ s experience, ability, and current competence to perform the privileges being requested.
• A“ peer” is defined as an individual from the same discipline( e. g. physician and physician) and essentially the same qualifications and training.
• Do NOT include: residency / fellowship directors, residents, fellows, family or other
Nevada State Pharmacy Primary source verification through the Nevada State Board of Pharmacy Professional Peer References List three professional peer references knowledgeable about the applicant’ s experience, ability, and current competence to perform the privileges being requested.
A“ peer” is defined as an individual from the same discipline( e. g. physician and physician) and essentially the same qualifications and training.
Do NOT include: residency / fellowship directors, residents, fellows, family or other relatives
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