If you are requesting privileges at a facility, and verification of your terms of coverage at Washington University is required for a new employer or insurer, you may submit a request for confirmation of insurance by clicking on the link provided below:

If malpractice claims history is needed, you will need to provide us with a written and signed release before the information will be provided. A release form (suitable for printing) may be accessed by clicking on the link provided below:

Any questions regarding these forms may be directed to Chrissy Hagaman of the Risk Management Office at (314) 362-6956, or via e-mail at mhagaman@wustl.edu@wustl.edu.