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Visitor Restrictions Update: Because flu & RSV cases are on the rise, starting November 16, children 12 and younger are restricted from visiting hospitals, certain inpatient facilities, and all emergency departments. Learn more.

Please follow the steps below to complete Phase I - Clinical Privileges Update of the reappointment process.

If you wish to keep a privilege that is attached to maintenance criteria, you must provide proof of that maintenance criteria in order to maintain the privilege.

If you are requesting a privilege you currently do not have, you must meet the initial criteria for that privilege.

If you have additional questions, you may email Shauna Guy Noel, Supervisor, Medical Staff Services.

Please click on the link below to print and complete the Delineation of Privileges form.

Cherokee Medical Center - Physician Forms


Emergency Medicine

Family Medicine


Internal Medicine


Pediatric General Dentistry






Cherokee Medical Center - Advanced Practice Provider (APP) Forms

Anesthesia - APP

Nurse Practitioner - APP

Physician Assistant - APP

Blank Form - APP

Thank you for your commitment to Atrium Health Floyd!