MSUCOM / SCSStatewide Campus System

For Administrators

Evidence of Implementation of Corective Action Plan Format

Date (must be with-in 6 months of the receipt of the AOA written acknowledgement of the plan)

Maura Biszewski
Manager of Inspection Services, Postdoctoral Training
American Osteopathic Association
142 Ontario Street
Chicago IL 60611

RE: (insert program ID and specialty) Corrective Action Plan

Ms. Pierson:

Enclosed please find documentation of the Evidence of Implementation of the Corrective Action as it relates to the (insert specialty) training program.

(Insert the deficiency number and description as noted in the AOA letter)

The following information is submitted as the Evidence of Implementation of the Corrective Action.

(Insert steps that were taken to correct the deficiency and attach supporting documentation that the deficiency was corrected.)

It is my understanding that (insert hospital name) has now complied with the requirements of the Evidence of Implementation of the Corrective Action Plan. Please notify me at your earliest convenience in the event that we have not complied.

Thank you for your usual cooperation and assistance.

Respectfully,

Name
Program Director or DME
Institution
CC: Martha Ribbens, Statewide Campus System