TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER f: EMERGENCY SERVICES AND HIGHWAY SAFETY
PART 515 EMERGENCY MEDICAL SERVICES, TRAUMA CENTER, COMPREHENSIVE STROKE CENTER, PRIMARY STROKE CENTER AND ACUTE STROKE READY HOSPITAL CODE
SECTION 515.APPENDIX G CREDENTIALS OF GENERAL/TRAUMA SURGEONS LEVEL I AND LEVEL II

 

Section 515.APPENDIX G  Credentials of General/Trauma Surgeons Level I and Level II

 

List each surgeon by name

 

Check appropriate categories regarding trauma care experience and operating room privileges

 

Signed by CEO/Hospital Administrator

 

 

 

Surgeon

Name

 

 

 

T= Trauma Surgeon

G= General Surgeon

 

 

Two years post-residency trauma care experience

 

 

Independent

OR

privileges

 

20 hrs. for every two years trauma-related CME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature

Hospital CEO/Administrator

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Typed Name

Hospital CEO/Administrator

 

Date

 

 

(Source:  Amended at 25 Ill. Reg. 16386, effective December 20, 2001)