Thank you for your interest in joining the Marin General Hospital Medical Staff. To begin the process, please send an e-mail to Medical Staff Credentialing Coordinator, Jane Bartesch, at bartesj@maringeneral.org and include the following information.

• Your full name
• Your e-mail address (to ensure we are able to respond to your request)
• Your street address, city, state & zip
• Your phone number
• The medical specialty privileges for which you wish to apply
• The name of any existing medical group or local office practice you anticipate joining

To contact the Credentials Coordinator please call (415) 925-7114. Allied Health Practitioners must contact the Coordinator directly for more information prior to receiving an application.

Once the e-mail request is received, the Medical Staff Office will respond with an e-mail to the address you have designated. That e-mail will include, as Microsoft Word attachments, our medical staff application, any specialty privilege applications that you have requested from the list above, and instructions on how to complete the process.

Medical Staff Services is located at Marin General Hospital, Level 2 of the East Wing. Mail can be sent to the Medical Staff Credentials Committee c/o MGH Medical Staff Services Box 8010, San Rafael, CA 94912.

As part of the application process you will be asked to acknowledge that you have been furnished with a copy of the Medical Staff Bylaws Rules and Regulations, and agree to be bound by the Bylaws and the rules and regulations of the Medical Staff. Links to downloadable PDF versions of the Bylaws & Rules are provided below.

Bylaws

Rules

Medical Staff Flu Immunization & PPD/TB Screening & 2011 Fall Immunization Clinics Schedule

If you have any questions about the Flu/PPD Clinic schedules at MGH, please contact:

All Medical Staff members and allied health professionals who actively practice onsite at MGH must submit a PPD/TB screening result annually, and either an influenza immunization record OR a “flu decline” form. Each actively practicing practitioner must comply annually by providing the following documentation to the Medical Staff Office (FAX #415-925-7117).

1. Your completed PPD/TB screening test. If you have tested positive in past, you must complete & send the PPD/TB form to record a symptom review.

2. Your current seasonal influenza immunization.

If you got a PPD/TB or Flu shot elsewhere, you may FAX it to # 415-925-7117.

New! Online Flu Vaccine & PPD/TB Response Forms

If you decline the flu vaccine, or do not need a PPD/TB test because you got it elsewhere or have tested positive, you can download the forms below, print them and fax them to 415-925-7117. Declines are only accepted for medical reasons.

• MGH Influenza Vaccination Decline Form
• MGH PPD/TB Screening Test Form