Affiliation Letter Tool

Step 1: Enter Information

Welcome to Mountains Community Hospital's Affiliation Letter Tool

We receive a number of requests for verification of Mountains Community Hospital Medical/Allied Health Staff membership. In an effort to expedite our response to those queries, the Medical Staff Services Department is pleased to provide you with this Affiliation Letter Tool for easy online verification.

By utilizing this site, you attest that your organization is a healthcare entity that utilizes this information for protected peer review purposes only. Additionally, you are confirming that you have a current release form signed by the Physician/Practitioner on file granting you permission to obtain information regarding his/her affiliation and privileges from our facility.

To use the tool, simply follow the three steps below. The Affiliation Letter can be printed immediately. If you need assistance, please contact the Medical Staff Services Department at 909-336-3651 Ext: 3211.

 

Enter Physician Information

Please enter all or part of the doctor's name in the form below. Once you have entered the information, click submit to view matching physicians.

Name: