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Volunteer Physician Application DOC  Form

Volunteer Physician Application DOC Form

Use a Volunteer Physician Application doc template to make your document workflow more streamlined.

I am only protected to the extent allowable by the Federal Tort Claims Act. Have you ever been assessed a surcharge or rated in a high-risk class for your specialty by your professional liability insurance carrier based on your liability history arbitrated mediated or litigated within the past 10 years If yes provide information on each case. Volunteer Physician Application Name Date of Birth Address Office Phone Email Cell Phone What is your current place of employment What foreign languages...
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