May 18, 2012

RE:

To Whom It May Concern:

In response to your request, this is to verify that the above-named physician is/was a member in good standing at Temple Community Hospital, which is accredited by the Joint Commission. This individual is/was affiliated with Temple Community Hospital as follows:

Continued membership on the Medical Staff of Temple Community Hospital is contingent upon compliance with the Medical Staff Bylaws, Rules and Regulations; satisfactory participation in the duties and responsibilities of the Medical Staff as assigned; current clinical competence; a health status that does not affect his/her performance of responsibilities; and the maintenance of accepted ethical standards. All members are evaluated utilizing criteria-based medical staff monitoring activities. There are no current or pending investigations involving this physician.

It is not our policy to provide a copy of the practitioner's privileges. Each member receives a copy of his/her approved, delineated clinical privileges at the time of appointment and each subsequent reappointment. If you require a copy, please contact the practitioner directly.

If your facility requires an activity report to evaluate clinical competence, please advise the physician to contact our Health Information Management Department at (213) 382-7252, ext. 260 or fax (213) 388-8236.

The information in this letter was obtained directly from our credentialing database and is updated on an ongoing basis. If this information does not agree with your records, if more information is required, or if you have any questions, please contact the Temple Community Hospital Medical Staff Services Department at (213) 382-7252, ext. 210 or fax (213) 381-5260.

Sincerely,
Medical Staff Services Department