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- Review the 'Required Qualifications' section carefully. Ensure you meet all criteria, including education, training, and clinical experience.
- In the 'Core Privileges' section, check all privileges you wish to request. Be sure to understand each privilege listed.
- For any additional qualifications or special noncore privileges, provide detailed information as required in their respective sections.
- Complete the acknowledgment section by signing and dating it to confirm your understanding of the privileges requested.
- Finally, submit your completed form through our platform for processing.
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