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Checklist for scheduling a relief doctor.



                       Due at least one week prior to scheduled relief doctor shift.
                       Initial each line when complete.
                       Sign and date below when done.
                       Turn in to owner or ED AT LEAST ONE WEEK PRIOR to scheduled shift.


                       ___  Doctor has confirmed schedule with shift time including lunch

                       ___  Doctor is appropriately scheduled in AVImark as listed in procedure.

                       ___  Lay staff has been appropriately scheduled on the staff schedule as listed in
                       procedure.

                       ___  Receptionists have been trained and informed to schedule under this doctor as
                       listed in procedure



                       _________________________________
                       Signed

                       _________________________________
                       Date

                       _________________________________
                       Title
























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