Union West Surgery Center forms

Mask and Visitor Policies: Following CDC and state of NC guidance, masks are still required in all Atrium Health facilities. View our current visitor policy.

Please follow the steps below to complete Phase I - Clinical Privileges Update of the reappointment process for Union West Surgery Center.

1) PRINT and COMPLETE - the Delineation of Privileges (DOP) that reflects your specialty/current practice

2) NOTE - 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

3) NOTE - if you are requesting a privilege you currently do not have, you must meet the initial criteria for that privilege.

4) RETURN the form(s) to the coordinator assigned to you