Contractor Compliance

CERTIFICATION OF MEETING UNION HOSPITAL HEALTH GROUP'S

POLICY REQUIREMENTS FOR NON-EMPLOYED PERSONNEL

Union Hospital Inc. refers to Union Hospital, Terre Haute, Indiana and Union Hospital, Clinton, Indiana, and Employed Physician Offices.

UH Inc.'s policies, including the specific requirements listed below can be requested from the Human Resource Department at 812-238-7654 or the Corporate Compliance Department at 812-238-7533 or Click Here

*This Certification Form must be submitted to the Human Resource Department by January 1st of each year certifying to the prior calendar year status.

Email: ahrjmd@uhhg.org

Fax: 812-238-7643

Personnel that do not meet the requirement should NOT be listed on this form but reported in written format to:

Corporate Compliance Department

1606 N. 7th Street

Terre Haute, IN 47804

(812) 478-4191 - Fax (812) 478-4195.