Before an application can be released, you must first complete a Request for Application form. Please complete the form for initial appointment and for adding a new facility.
Completion of the form will allow you to apply for hospital credentialing, MHMD membership or the Health Plan.
Medical Staff Credentialing appointments are aligned to meet the single reappointment period. Prior to your reappointment deadline, you will receive two emails with your login username and password information.
In order to ensure timely processing, please complete your reappointment application promptly. If you are interested in requesting additional hospital affiliations, request an application.