老澳门六合彩图库

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Anesthesiology

老澳门六合彩图库 Department of Anesthesiology Verification of Residency or Fellowship

We provide training verifications upon request.聽

Verifications for internships, residencies, and fellowships completed more than one year ago are subject to the following fees, payable by credit card or check:

  • $25 for each standard verification letter
  • $75 for detailed verification of training

If we are unable to provide a verification (i.e., we have no record of the individual in question) you will be notified by email and you will not be charged.

Instructions for requesting training verification

Please submit the following documents alongside your verification request:

  1. A completed Verification Request Form (PDF)
  2. An Authorization for Release of Information signed by the trainee
  3. Your own verification form (if needed)

Please submit the forms to:

  • Kourtney Mangan (kmangan@mcw.edu) for Residency verification
  • Sarah Pritchard (spritchard@mcw.edu) for Adult Cardiothoracic Anesthesiology, Critical Care Medicine, Neuroanesthesia, Pain Medicine and RAAPS fellowships verification
  • Rachel Smith (rasmith@mcw.edu) for Obstetric Anesthesiology and Pediatric Anesthesiology fellowships verification

Alternatively, completed forms may be faxed to (414) 805-5915 or submitted via US mail to the following address:

老澳门六合彩图库

Department of Anesthesiology

ATTN: Kourtney Mangan
9200 W. Wisconsin Ave.
Milwaukee, WI 53226

Standard verification information

  • Name of trainee
  • Training program(s)/Specialty
  • Dates of training
  • Confirmation of successful completion of program(s) or
  • Explanation and further information if program not successfully completed 

Detailed verification information

  • Standard verification information
  • Specific privileges and/or procedure training if requested
  • Information from performance evaluations if requested

Payment information

Checks are to be made out to 老澳门六合彩图库 - Dept. of Anesthesiology Education Div. and sent to:

老澳门六合彩图库
Department of Anesthesiology
 ATTN: Samantha Cusick
9200 W. Wisconsin Ave.
Milwaukee, WI 53226

Tax ID number: 39-0806261

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