Carolinas HealthCare System

Providers will receive their reappointment application via the email address on file with the Medical Staff Office 120 days prior to the expiration of their current term. A memo is mailed to the provider’s office address a few weeks prior to the distribution of the Reappointment to confirm the email address on file. An incomplete application will result in the loss of your privileges.

Please note if you wish to voluntarily resign your membership and privileges at the end of the current term you will not need to complete the application. Please be sure to notify Staci Hightower, Reappointment Supervisor, of your resignation.

Step 1: OPEN AND REVIEW - Mandatory - Medical Staff Education PowerPoint

  • Please open and read the attached slides relating to Medical Education for EMTALA, Emergency Management, Corporate Privacy and Pain Assessment and Management. **Please note you will be signing an attestation in your application documents indicating you have reviewed this PowerPoint.
  • Access the Documentation Library for Moderate Sedation Tests (to maintain these privileges) and Influenza Exemption forms (if applicable).

Step 2: Log in to the Application Module 

  • Check all information carefully for completeness and accuracy.
  • Click on Apps -> Provider Additional Forms
  • "Click to Sign" to open document(s)
  • PRINT the Delineation of Privileges (DOP) form(s) 
  • COMPLETE the form(s) to indicate your current privileges.
  • DO NOT sign these electronically as you will print these to be emailed to ReappointmentMSS

Step 3:  All sections included in the application MUST BE COMPLETED or your application will be deemed incomplete.

  • Click On Apps -> Carolinas HealthCare System Tab 
  • Edit each field on the left-hand side
  • Health Status - input your TB and Flu (documentation required)
  • Answer all Questions
  • Click "Review Information"
  • Go to "Sign Documents"
  • "Click to Sign"  the Reappointment Application
  • TYPE IN YOUR FULL NAME at the bottom of the document
  • "Click to Sign" the Peer Evaluation, You will PRINT this form for a peer to complete.
  • Click "SUBMIT" once all documents are signed
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