Midwifery Staff Appointment Application

Instructions

Please complete the following appointment application.

Make sure you have proof of documentation such as: CV, proof of immunization; copy of license; proof of registration with the College of Midwives of Ontario; photocopy of current liability insurance coverage; and proof of immunization to submit with your application as you will be asked to upload.

You will not be able to save this application and return to add your documentation.

Post Graduate Training/Qualifications

Diplomas, Certificates, Degrees, Fellowships, etc.

Graduate Training/

Internships, Residencies, Research Fellowships, etc. in reverse chronological order

Professional Practice/

Hospital Staff Memberships/

Past and Present

Click next to complete the Authorization of the Release of Information

Authorization for the Release of Information

Click next to complete the Electronic Signature Authorization Form

In accordance with the Authentication Electronic Signature Policy in the Administration Manual on Authentication/ Electronic Signature which I have read, all reports which I dictate will be considered authenticated on the basis of my signature below, the utilization of my unique three digit dictation I.D. code, and the statement of my name at the beginning of each piece of dictation, unless otherwise indicated. The electronic signature will be considered replacement of my hand-written signature for electronically generated reports/orders by utilization of my sign-on and password. It is the responsibility of the dictating individual to read the transcribed report. If an edit is required, the corrections must be made in writing on the original and returned to the appropriate department, or an addendum must be dictated. Refer to policy Authentication Electronic Signature Policy.

Authentication Electronic Signature Policy

Click next to complete the Privacy and Confidentiality Agreement – Medical Staff

Internet Access Policy

Click next to complete the SAH Medical Directives

Midwives

WCH 01 Fetal Maternal Blood Screening
WCH 02 Prevention of Early Onset Neonatal GBS Disease
WCH 03 Midwives Assisting at C-Sections
WCH 08 –R Admission Process for all Newborns
WCH 09 – R Sucrose 24%