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Medical Staff Verifications

You've been asked to complete a professional reference for a health-care provider who has applied for appointment/reappointment to Osceola Medical Center. Please complete all sections of this online form with (*). If you have any questions or would like to submit a PDF, please email OMC's Credentialing at This email address is being protected from spambots. You need JavaScript enabled to view it. or fax 715-294-4822.
Please let us know who you are completing this reference on.

Please let us know your name.

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Please write a what setting you know the applicant.

Please let us know your email address.

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In general, I would classify the applicant as follows:
Please rate this applicant on his/her medical/clinical knowledge.

Please rate this applicant on his/her technical and clinical skills.

Please rate this applicant on his/her patient care.

Please rate this applicant on his/her communication skills.

Please rate this applicant on his/her rapport skills.

Please rate this applicant on his/her teamwork skills.

Please rate this applicant on his/her Clinical Judgement skills.

Please rate this applicant on his/her professionalism.

Please let us know if the applicant is qualified for clinical privileges.

Please let us know if you recommend this applicant for participation.

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By typing my name I am affixing my legal signature to the document and the legal effect cannot be denied simply because the signature is not in writing.
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Testimonial

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Dr. Nguyen was amazing. He is so friendly. He answered all your questions. He is very professional. I ... first time we've ever seen him, so I would definitely recommend him as a provider. Our experience was nothing but great, the whole time.
Survey Feedback for
Osceola Clinic - Tony Nguyen, MD
Nicole did a great job on the well child visits. She really encouraged healthy lifestyle, and took time to talk to my daughter and get her feedback, and include her in care.
Survey Feedback for
Osceola Clinic - Nicole Svihel, PA-C
I was so pleased with how much time the Dr spent going over my medical history. So happy to have found this great Dr.!
Survey Feedback for
Osceola Clinic - Amanda Tembreull, MD
An excellent facility, a wonderful Clinic, incredible staff and somewhere I will always go back to.
Survey Feedback for
Walk-In Clinic - Coby Somsen, FNP
Just a very friendly place with a great staff of people from the receptionist to the nurses and the doctor all very professional and very friendly great place!
Survey Feedback for
Walk-In Clinic - Natalia Cropper, FNP
Both the nurse and doctor were caring and effective in their care of me. They kept the mood light, but confident in dealing with medical condition. Excellent care.
Survey Feedback for
Erik Severson - Emergency Department

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