Clinical background review
Template
Research and evaluate physicians based on their background, resumes and academic prestige. Analyse and rate all information and, then contact their referrals before making a positive or negative decision.
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Template structure
See how this template is structured. As this is just an example, you can customize it.
Start form
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1. Physician name
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2. Specialty
- Orthopedics
- Oncology
- General practice
- Psychiatry
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3. License number
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4. Personal statement
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5. Attach your résumé.
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6. Email address
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7. Phone number
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8. 1. Name
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9. 1. Phone
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10. 2. Name
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11. 2. Phone
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12. 3. Name
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13. 3. Phone
Evaluator
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1. Evaluator
Background check
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1. Graduation
- 1
- 2
- 3
- 4
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2. Scientific knowledge
- 1
- 2
- 3
- 4
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3. Knowledge within the field of expertise
- 1
- 2
- 3
- 4
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4. General medical practice
- 1
- 2
- 3
- 4
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5. Years of experience within the field
- 1
- 2
- 3
- 4
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6. Reputation
- 1
- 2
- 3
- 4
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7. Scientific community acceptance
- 1
- 2
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- 4
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8. Papers and other publications
- 1
- 2
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- 4
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9. Interpretation of clinical studies
- 1
- 2
- 3
- 4
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10. Additional comments
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11. Highlights
- Deep scientific knowledge
- Relevance within the field of expertise
- Bibliographical references
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12. Background check approval
- Approved
- Not approved
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13. Reason for non-approval
Reference check
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1. Contacted references from the start form
- Reference #1
- Reference #2
- Reference #3
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2. Final review and comments
Final approval
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1. Rating
- 1
- 2
- 3
- 4
- 5
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2. The background check was:
- Positive
- Negative
Phisician approved
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1. Documentos Post Evento