Medical Staff Office New Medical and Affiliated Medical Staff applications Re-appointment of medical and affiliated medical staff Addition or change of privileges for current medical staff and affiliated staff Notification about change in practice location, address, malpractice insurance carrier or changes to any contact information Credentialing with payers Liability Insurance applications and assistance For additional information or questions, please contact the Medical Staff office at (810) 275-9333 ext 116 or email us at [email protected]. AFFILIATION VERIFICATION REQUEST INFORMATION CONTACT US Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *Email *Phone *I am.. *I am..PatientphysicianMedical PracticeHow Did You Find us?How May We Help you?Submit