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Family Medicine Clinical Privileges
Initial Applicant - To be eligible to apply for privileges in family medicine, the applicant must meet the following criteria: Successful completion of an
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Reporting Of Medical Conditions Affecting Driver Safety
privilege. The report may be made in writing a letter or by using PennDOTs condition specific medical form(s) or the Initial Reporting Form (DL-13).
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ANESTHESIA PRIVILEGE FORM
PRIVILEGES NOT INCLUDED ON THIS FORM: A request to perform any procedure or treatment not included on this form must be submitted to the Attending Staff Office
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