Physician/Allied Health Requests
We are delighted that you have chosen St. Luke’s to be a part of your professional experience. You will find the steps needed, to continue your Physician/Allied Health journey, listed below.
- Review the Clinical Orientation Module, Non-Employed Physician Standards of Ethical Business Practice (Attachment C), Excerpt of Medical Staff Bylaws – Leave of Absence, Departmental Information Sheet, Standards of Ethical Business Practice Policy, Compliance Plan Summary Policy, False Claims Education Policy, Restraint Use for Non-Violent Behaviors Policy, Behavioral Restraint Use for Violent/Self Destructive Behaviors Policy.
- Print and complete Clinical & Non-Clinical Attestation Form, Provider IT Access Form, and Non-Employed Physicians Certification Statement (Attachment D).
- Provide proof of annual influenza vaccination.
- St. Luke’s requires influenza vaccination for individuals employed or accessing facilities for learning experiences. If you have a medical or religious reason for declining the influenza vaccine, please be aware that you will be required to submit declination forms and follow St. Luke’s guidelines for masking during influenza season. Influenza, administered September – March. (Date may be extended in the event that there is continued high flu activity in our area.)
- Contact Medical Staff office, at 419-891-8019, to schedule your Cerner training, held the 1st Wednesday of every month.
- Stop at the Human Resources department to have your picture taken for your badge, so it can be picked up on your first clinical day at St. Luke’s Hospital. This can be done up to two (2) weeks prior to your start date, with a minimum of two (2) days before your start date.
Note that all paperwork must be completed and received by the Medical Staff office before a Physician/Allied Health can start their first clinical day.
Physician/Allied Health Required Materials:
- Clinical Orientation Module (pdf)
- Non-Employed Physician Standards of Ethical Business Practice (Attachment C) (pdf)
- Excerpt of Medical Staff Bylaws – Leave of Absence (pdf)
- Departmental Information Sheet (pdf)
- Standards of Ethical Business Practice Policy (pdf)
- Compliance Plan Summary Policy (pdf)
- False Claims Education Policy (pdf)
- Restraint Use for Non-Violent Behaviors Policy (pdf)
- Behavioral Restraint Use for Violent/Self Destructive Behaviors Policy (pdf)
Print and complete:
- Attestation Form – Clinical & Non-Clinical (pdf)
- Provider IT Access Form (pdf)
- Non-Employed Physicians Certification Statement (Attachment D) (pdf)