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Verification of Insurability Screening

Prospective clinical employees are required to complete and submit an application for verification of insurability along with required supporting documentation to the Office of General Counsel (OGC)/Legal Department.  

 Applicants may submit their completed application along with required supporting documentation 180 days prior to their tentative hire date.   A minimum of 30 business days is required to process an application after it along with all supporting documentation is received. 

 Applications are fillable pdfs; applicants should type in their responses and save a copy prior to submitting.  An applicant may submit their application via email, fax, or mail.  Once the application and required supporting documentation is received, the applicant and hiring department will receive an email acknowledgment.  If submitted applications are incomplete or any additional information is needed, the Office of General Counsel/Legal Department will reach out to the prospective clinical employee and the hiring department to inform what items are needed.  

 Please ensure that the correct application is completed; there are two separate applications.   

• Please contact hiring department to obtain UMMC Screening Application - MD DO
• UMMC Screening Application – Advanced Practice Providers, Audiologist, Dentists, SLP

If our office can be of any additional assistance or you have questions, please call 601-984-1763 or email riskanalyst@umc.edu.