Medical Board Attestations for Clinical Cases

1. Obtain detailed information required by the particular specialty board along with the submission instructions and due date. Present a copy of this request to HIM

2. Contact HIM at hs-him@ucdavis.edu with your request please include the following:

• Full name, contact information (phone and e-mail), and practitioner’s PI
• A copy or description of the list/report needed, detailed criteria, timeframes of the required cases by the board
• Date range of clinical cases requested
• Date when you need to receive requested report from HIM

3. HIM department will generate a report using our standard protocol, only using cases performed and documented within UC Davis Health’s Legal Medical Record. HIM is responsible for validating the report to ensure accuracy.

4. The report will be sent to clinical practitioner for review and confirmation.

5. Once the accuracy of the report is confirmed by the clinical practitioner, it will be signed by the HIM Director. Signatures and identity will be attested via notary within HIM as applicable.

6. HIM staff will provide copies of final documentation to requester or upload the report.