Instructions for MD Visiting Residents 

PART I: (To be completed by visiting resident applicant)

Applicant to complete top half of form. Application must have required documentation in order to be processed:

• Letter from visiting resident’s program director
• Proof of immunizations and personal health insurance
• Proof of professional liability
• Proof of OSHA/Worker’s Compensation compliance
• Completed training permit application/$50.00 check made out to the Arizona Medical Board

PART II: (To be completed by host department)

• Host Department approves elective rotation.
• Residency coordinator should review completed application, clearly identify elective rotation name and dates of elective.

• The Program Director’s signature is required.
• Forward completed application and ALL required documentation to the GME Office for processing.

GME Office:

• Review application packet for completion and eligibility of applicant
• Initiate request for affiliation agreement with home institution, if needed
• Process training permit application to the Arizona Board of Medical Examiners
• Assign physician ID number and DEA number (if applicable)
• Provide memo for parking privileges 

View Also:
Prerequisites
Instructions for DO visiting residents
Application form for all visiting residents