[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-197979-105":3,"detail-sidebar-cat-1-en-105":80,"doc-detail-197979-en":126},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","vascular-surgery-clinical-privileges","Vascular Surgery Clinical Privileges","","This document outlines the process and requirements for obtaining clinical privileges in vascular surgery at the University Hospital and Health System, University of Mississippi Medical Center. It includes an acknowledgement section where the practitioner confirms their qualifications and understanding of hospital policies, and a division chief's recommendation section to assess the applicant's suitability for the requested privileges. The document serves as a formal record for credentialing and ensuring patient safety by verifying the competence of medical practitioners in specific surgical specialties. The privilege request system ensures that only qualified individuals are granted the necessary permissions to perform procedures, adhering to strict medical standards and institutional guidelines, with provisions for emergency situations.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/forms/","Forms",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/vascular-surgery-clinical-privileges/197979/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/vascular-surgery-clinical-privileges/197979.png","ImageObject",442,249,{"name":42,"@type":43},"Arica Lee","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-10","2026-09-03",true,{"@type":52,"interactionType":53,"userInteractionCount":33},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What is the purpose of this document?","Question",{"text":62,"@type":63},"This document is for practitioners requesting clinical privileges in vascular surgery and outlines the requirements and recommendation process at the University Hospital and Health System.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"What must a practitioner acknowledge when requesting privileges?",{"text":67,"@type":63},"Practitioners must acknowledge that they are qualified by education, training, experience, and performance for the requested privileges and will adhere to hospital policies.",{"name":69,"@type":60,"acceptedAnswer":70},"What is the role of the Division Chief?",{"text":71,"@type":63},"The Division Chief reviews the requested privileges and supporting documentation, assesses the practitioner's health status, and makes a recommendation on whether to grant, modify, or deny the privileges.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},197979,1788472819,{"code":4,"msg":81,"data":82},"success",[83,88,93,98,103,108,112,117,122],{"id":84,"doc_module":22,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},11,"Presentations",90,"presentations",{"id":89,"doc_module":22,"doc_module_name":25,"category_name":90,"show_sort_weight":91,"slug":92},12,"Resumes",80,"resumes",{"id":94,"doc_module":22,"doc_module_name":25,"category_name":95,"show_sort_weight":96,"slug":97},14,"Invoices",70,"invoices",{"id":99,"doc_module":22,"doc_module_name":25,"category_name":100,"show_sort_weight":101,"slug":102},15,"Posters",60,"posters",{"id":104,"doc_module":22,"doc_module_name":25,"category_name":105,"show_sort_weight":106,"slug":107},16,"Social Media",50,"social-media",{"id":109,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":110,"slug":111},17,40,"forms",{"id":113,"doc_module":22,"doc_module_name":25,"category_name":114,"show_sort_weight":115,"slug":116},18,"Letters",30,"letters",{"id":118,"doc_module":22,"doc_module_name":25,"category_name":119,"show_sort_weight":120,"slug":121},21,"Paper Templates",5,"papers-templates",{"id":123,"doc_module":22,"doc_module_name":25,"category_name":124,"show_sort_weight":4,"slug":125},158,"General","general-158",{"code":4,"msg":81,"data":127},{"doc_id":78,"user_id":128,"nickname":42,"user_avatar":129,"doc_module":22,"category_id":109,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":135,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":136,"language":137,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":138,"faqs":139,"seo_title":140,"seo_description":12,"update_tm":79,"read_time":30},8796096645457,"https://ap-avatar.wpscdn.com/avatar/800003749518d68ffe3?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779345340919836971","| ACKNOWLEDGEMENT OF PRACTITIONER |\n| --- |\n| I have requested only those privileges for which by education, training, current experience, and demonstrated performance I am qualified to perform and for which I wish to exercise at University Hospital and Health System, University of Mississippi Medical Center , and I understand that:\u003Cbr>a. In exercising any clinical privileges granted, I am constrained by Hospital and Medical Staff policies and rules applicable generally and any applicable to the particular situation.\u003Cbr>b. Any restriction on the clinical privileges granted to me is waived in an emergency situation and in such situation my actions are governed by the applicable section of the Medical Staff Bylaws or related documents.\u003Cbr>Signed  Date  |\n| DIVISION CHIEF’S RECOMMENDATION (AS APPLICABLE) |\n| I have reviewed the requested clinical privileges and supporting documentation for the above-named applicant. To the best of my knowledge, this practitioner’s health status is such that he/she may fully perform with safety the clinical activities for which he/she is being recommended. I make the following recommendation(s):\u003Cbr>􀂆 Recommend all requested privileges.\u003Cbr>􀂆 Recommend privileges with the following conditions/modifications:\u003Cbr>􀂆 Do not recommend the following requested privileges:\u003Cbr>Privilege Condition/Modification/Explanation\u003Cbr>1.     2.     3.     4.    \u003Cbr>Notes |","cbCaigpoNrqyLpDq","https://ap.wps.com/l/cbCaigpoNrqyLpDq","pdf",303097,8,9,"English","# Acknowledgement of Practitioner\n# Division Chief’s Recommendation","[{\"question\":\"What is the purpose of this document?\",\"answer\":\"This document is for practitioners requesting clinical privileges in vascular surgery and outlines the requirements and recommendation process at the University Hospital and Health System.\"},{\"question\":\"What must a practitioner acknowledge when requesting privileges?\",\"answer\":\"Practitioners must acknowledge that they are qualified by education, training, experience, and performance for the requested privileges and will adhere to hospital policies.\"},{\"question\":\"What is the role of the Division Chief?\",\"answer\":\"The Division Chief reviews the requested privileges and supporting documentation, assesses the practitioner's health status, and makes a recommendation on whether to grant, modify, or deny the privileges.\"}]","Vascular Surgery Clinical Privileges | PDF"]