credentialing table of contents i. appointment to the ... - Orlando Health

(a)
(b)
(c)
(d)
(e)
The applicant's specific acknowledgment of the obligation upon appointment to the medical
staff to provide or make provision for continuous care and supervision to all patients within
the hospital for whom he or she has responsibility;
The applicant's agreement to abide by all such bylaws, policies, and directives of the
hospital, including all such bylaws, rules and regulations, and policies and procedures of the
medical staff as shall be in force during the time the applicant is appointed to the medical
staff of the hospital; and including any and all regulatory and accreditation requirements as
set forth by state and federal agencies and accreditation authorities; (01/09)
The applicant's agreement to accept committee assignments, emergency call, and such other
reasonable duties and responsibilities as shall be assigned to him or her by the medical staff;
(0109)
A statement that the applicant has received and read a copy of such bylaws of the hospital
and bylaws, rules and regulations, and policies and procedures of the medical staff as are in
force at the time of his or her application and that the applicant has agreed to be bound by
the terms thereof in all matters relating to consideration of his or her application without
regard to whether or not the applicant is granted appointment to the medical staff and/or
clinical privileges; and,
A statement of the applicant's willingness to appear for personal interviews in regard to his
or her application.
3. Burden of Providing Information:
The applicant shall have the burden of producing adequate information for a proper evaluation of
his or her current competence, character, ethics and other qualifications, and of resolving any
doubts about such qualifications. The applicant shall have the burden of providing evidence that
all the statements made and information given on the application are factual and true. (01/09)
4. Statement of Release and Immunity from Liability:
The following are express conditions applicable to any physician, dentist, and podiatrist during his
or her appointment or reappointment to the medical staff. By applying for appointment to the
medical staff and for clinical privileges the applicant expressly accepts these conditions during the
processing and consideration of his or her application, regardless of whether or not the applicant is
granted appointment to the medical staff and clinical privileges as well as for the duration of his or
her appointment: (01/09)
(a)
To the fullest extent permitted by law, the applicant or appointee extends absolute
immunity and release from liability to the hospital and its authorized representatives from
any and all civil liability arising from any acts, communications, reports, recommendations,
or disclosures involving the physician, dentist, or podiatrist performed, made, taken, or
received by this hospital and its authorized representatives in good faith during the course
of the business of the hospital specifically including, but not limited to, members of its
medical staff by or from any third party concerning activities relating to, but not limited to:
(01/09)
(1) Applications for appointment or clinical privileges, including temporary clinical
privileges; (01/09)
(2) Periodic reappraisals undertaken for reappointment or for increase or decrease in
clinical privileges;
(3) Peer review;
January 2010 Credentialing Policy & Procedures
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