Certificate of Insurance – Requests for Physician Credentialing

Periodically, an off campus site will request proof of insurance for physician credentialing purposes.
Risk Management will prepare a certificate of insurance document upon completion of the following:
1.    Confirmation that the physician is scheduled on Central Michigan University’s Medical Malpractice   
       insurance policy.
2.    Receipt of the following information:
  1. Physician Name
  2. Clinical Site Name
  3. Clinical Site Contact Person
  4. Clinical Site Address
 3.    Please e-mail information to young2sa@cmich.edu for handling.
 4.    Allow a minimum of 7 business days for completion of your Certificate of Insurance request.
 5.    Certificates of Insurance will be provided to requestor for distribution.


Central Michigan University • 1200 S. Franklin St. • Mount Pleasant, Mich. 48859 • 989-774-4000