Instructions for Medical Director, Co-Medical Director, Temporary Medical Director -or- Acting Medical Director Personnel Change

If you have a personnel change that is reference to a new Medical Director, Temporary Medical Director, or Acting Medical Director, Please complete the following (4) Steps.

1. Complete This "Change in Program Personnel" Template and put on your Program Letterhead.

2.    Provide a copy of the institution's Letter of Appointment and Acceptance.

       This letter must contain the following (3) items:                                      

• Signed by the President/CEO -or- Dean/Administrator                       

• Position Title

• The effective (start) date

 PLEASE NOTE: If you do not have a  "Letter of Appointment and Acceptance" and need to create one, you may use this template.

3.    Provide a copy of the Medical Director's CV.

4.     Please mail all (3) completed  documents to:     

CoAEMSP

Karen Franks

4101 W. Green Oaks Blvd.

Suite #305-599

Arlington, TX  76016