Medical Staff Services - Eaton Rapids Medical Center

Resources for Healthcare Providers

AHP Competency Checklist

Signature Page

Practitioner Performance Measures

ERMC Initial Application

Corporate Compliance Confidentiality Agreement

Conflict of Interest Disclosure Statement

Approval Page

Service Authority Request Form AHP Initial Application

AHP Competency Checklist

M edical Staff Acknowledgment Statements

If you would like privileges at Eaton Rapids Medical Center, please email [email protected] with your name, contact information, and specialty you would like an application for.

For more information, please contact one the following:

Heather Schragg, CIC, II | Director, Quality, Risk Management & Medical Staff

Eaton Rapids Medical Center

(Tel) 517.663.9442 | (Fax) 517.663.9450 | [email protected]

Brad Simons, BSN RN CEN TCRN | Chief Nursing Officer

Eaton Rapids Medical Center

(Tel) 517.663.9480 | [email protected]