Atrium Health Delineation of Privileges Forms Reference

If you have questions regarding the delineation of privilege forms, please contact Medical Staff Services.

Privilege Updated Request Form: If you would like to request an Update to the DOP, please submit this form.

Physicians	Advanced Practice Professionals (APP)
Medicine Specialties:	Medicine Specialties:
Addiction Medicine	Emergency Medicine
Allergy and Immunology	Family Medicine
Cardiology	Hospice and Palliative Medicine
Dermatology	Internal Medicine and Sub-Specialties
Emergency Medicine	Neurology
Endocrinology	Ophthalmology
Family Medicine	Optometry
Gastroenterology	Pediatrics
Hematology-Medical Oncology	Physical Medicine & Rehabilitation
Hospice and Palliative Care	Psychiatry
Hospitalist	Psychology
Hyperbaric Medicine and Wound Care	Radiology
Infectious Disease	Stanly Wound Care
Internal Medicine to include Sub-specialties
Medical Genetics and Genomics	Surgical Specialties:
Medical Toxicology	Certified Nurse Midwife
Nephrology	Certified Registered Nurse Anesthetist
Neurology	Dentistry
Pain Medicine	Neurosurgery
Pathology	Obstetrics & Gynecology
Pediatrics	Oral & Maxillofacial
Pediatric Cardiology	Orthopaedic Surgery
Physical Medicine and Rehabilitation	Otolaryngology
Psychiatry	Plastic Surgery
Pulmonary Disease-Critical Care	Podiatry
Radiology	Registered Nurse First Assist
Rheumatology	Sedation
Sedation	Surgery
Sleep Medicine	Thoracic Surgery
Sports Medicine	Urology

Surgical Specialties:
Anesthesiology
Dentistry
Neurological Surgery
Obstetrics and Gynecology
Ophthalmology
Oral & Maxillofacial
Orthopaedic Surgery
Otolaryngology
Pediatric General Surgery
Peripheral Endovascular Disease
Plastic Surgery
Surgery
Thoracic Surgery
Urology