PEI Medical Staff Re-appointment Request

You may apply for re-appointment to Health PEI Medical Staff providing you are licensed to practice medicine in PEI and have maintained your professional qualifications since your previous appointment. Health PEI Medical Staff include physicians, dentists, and nurse practitioners providing care in hospitals, and other Health PEI facilities and trainees in each of these categories. Complete the online form below to request re-appointment to Health PEI Medical Staff.  

What do I need to complete the online form?

You will be asked to provide:

  • Detailed personal and professional contact information including the name and number for a designated alternate contact when you are unavailable to receive critical results information. (Medical Affairs will not share contact information with patients or hospital unit staff.) 
  • Medical staff category, includes physicians, dentists, nurse practitioners, and trainees (drop-down list with brief description provided)
    • If you request a change in medical staff category you must provide details.
  • All sites for hospital privileges including naming departments and associated procedural privileges, i.e. Family Medicine, Internal Medicine, Pediatrics. 
  • Communities you intend to serve.
  • Preferred method for communication for the following:
    • Sentinel disaster 24/7
    • Urgent/emergent lab results
    • QEH/PCH telecommunications
    • Routine communications
  • Proof of medical liability coverage, (i.e. CMPA # or equivalent)
  • Assertion of professional good standing or disclosure of malpractice action in the past year or complaint investigation by a hospital or professional college
  • Continuing Medical Education since last appointment (Upload field provided for MainPro or MainCert certification)

How do I upload my MainPro or MainCert certification(s) for professional education?

You can upload certifications in gif, jpg, png, txt, rtf, pdf, doc, docx, ppt, pptx, xls, or xlsx format.

If your certifcation is in HTML format, you can convert it to PDF format following these steps:

  1. Open the HTML file in a web browser.
  2. Right click on the file while viewing it in the browser and select Print
  3. Choose Save as PDF or Print to PDF under the List of Printers or the Print Destination, then click the Save or OK button.
  4. A window will appear that asks you to save the PDF file. Choose the location where you want to save it and click the Save button.

Can I print my online application?

You can print your online application on the preview screen after filling out all of the required fields. You'll see a print button that allows you to do this.

Can I save my application before I submit it?

You can't save your application before submitting. 

What if I have questions about this form?

Please contact:

Willie MacGuigan, Medical Affairs Coordinator
Medical Affairs

Telephone:  902-218-3570

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General Inquiries

Health PEI
PO Box 2000
Charlottetown, PE   C1A 7N8

Phone: 902-368-6130
Fax: 902-368-6136

Your Health Privacy

Media Inquiries
Phone: 902-368-6135

Health PEI Board of Directors

If you are experiencing a medical emergency, call 9-1-1 or go to the nearest emergency department.

If you are unsure what to do about a health issue or if you need health information, call 8-1-1.

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