 |
Joining the MPHO
If you are a physician with priveleges at Medina General Hospital
and have a status of Active, Associate, Provisional, or Other,
you qualify for membership in the MPHO.
Download and complete the forms below.
Please ensure all areas and signature blocks are completed, and
submit the following to the address on the letterhead:
- The completed Provider
Application,
- MPHO
Physician Participation Agreement,
- MPHO
Addendum,
- Accompanying documents as noted in Section XIV of the Application
- Initial membership fee in the amount of $1500.000 per physician
made payable to the Medina PHO.
Once received in their entirety, the applications will be credentialed
and submitted to the Professional Services Committee and Board
of Trustees for review and approval. You will receive notice
of the approval status via letter.
If you have any questions, I may be reached weekdays at
(330) 723-4646 .
|
|
Medina,
Oh 44256