果冻影院

header-logo
what
Anesthesiology

果冻影院 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:

果冻影院

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 果冻影院 - Dept. of Anesthesiology Education Div. and sent to:

果冻影院
Department of Anesthesiology
 ATTN: Samantha Cusick
9200 W. Wisconsin Ave.
Milwaukee, WI 53226

Tax ID number: 39-0806261

© 2024 果冻影院.  All rights reserved.  | Terms and Privacy 

Non-Discrimination Statement
The 果冻影院 (果冻影院) is committed to fostering a diverse community of outstanding faculty, staff, and students, as well as ensuring equal educational opportunity, employment, and access to services, programs, and activities, without regard to an individual's race, color, national origin, religion, age, disability, sex, gender identity/expression, sexual orientation, marital status, pregnancy, predisposing genetic characteristic, or military status. Employees, students, applicants or other members of the 果冻影院 community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic. 果冻影院’s policy as well as federal and state laws and regulations prohibit unlawful discrimination and harassment.