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Provider Resources

Physician Verification

Instructions for verification of medical staff or Allied Health Professional staff appointment.

Please use this link in order to obtain completion of verification in a timely manner:

  1. Click on the link and it will open up a portal
  2. Fill in last name *mandatory field
  3. Fill in first name
  4. Fill in the birth date *mandatory field
  5. Fill in your name *mandatory field
  6. Your title *mandatory field
  7. Your organization name *mandatory field
  8. Address *mandatory field
  9. City, state, zip *mandatory field
  10. Once you click on "Click here to search"
  11. At the bottom of the page, the name will appear
  12. Click on the name you are searching for and the letter will generate
    NOTE: This may take a few minutes to generate, we have also had individuals needing to hold the control button down while it is processing
  13. Click "Print" on your toolbar

If you cannot find the provider requested, please fax your request and a signed consent for release to our office. (See fax number below)

Medical Staff Services
Clinton Memorial Hospital
610 W. Main St.
P.O. Box 600
Wilmington, OH 45177
937.283.9774 (fax)

Contact Us

Clinton Memorial Hospital
610 W. Main St.
Wilmington, Ohio 45177