Medical College of Wisconsin Department of Anesthesiology Verification of Residency or Fellowship

Verifications for internships, residencies, and fellowships completed more than one year ago are subject to the following fees, payable by credit card or check:

• $25 for each standard verification letter
• $75 for detailed verification of training

If we are unable to provide a verification (i.e., we have no record of the individual in question) you will be notified by email and you will not be charged.

Instructions for requesting training verification

Please submit the following documents alongside your verification request:

1. A completed Verification Request Form (PDF)
2. An Authorization for Release of Information signed by the trainee
3. Your own verification form (if needed)

Please submit the forms to:

• Kourtney Mangan (kmangan@mcw.edu) for Residency verification
• Sarah Pritchard (spritchard@mcw.edu) for Adult Cardiothoracic Anesthesiology, Critical Care Medicine, Neuroanesthesia, Pain Medicine and RAAPS fellowships verification
• Rachel Smith (rasmith@mcw.edu) for Obstetric Anesthesiology and Pediatric Anesthesiology fellowships verification

Alternatively, completed forms may be faxed to (414) 805-5915 or submitted via US mail to the following address:

Medical College of Wisconsin

Department of Anesthesiology

ATTN: Kourtney Mangan
9200 W. Wisconsin Ave.
Milwaukee, WI 53226