Medical Doctors (MD and DO) and dentists (DMD and DDS) are eligible.

A written request must be submitted to the Medical Staff Office. For your convenience, a request form may be completed and submitted on line. Requests may also be submitted in writing to the Medical Staff Office.

Following approval by the Chief Executive Officer, you will be provided with a preapplication.

The completed forms must be submitted along with all requested documents to the Medical Staff Office.

The Chief Executive Officer will review the preapplication form. Following approval, you will be supplied with the full application via mail or informed otherwise. The application fee is $250.

The original completed application, required documents and application fee must be returned to the Medical Staff Office. A postage paid return envelope is provided for your convenience. Receipt of the application and documents will be acknowledged by e-mail or letter. If you have not received an acknowledgement within one week, please contact the Medical Staff Office.

The application will be thoroughly reviewed and processed. This includes review and verification of credentials, training, references, current and prior affiliations, other information in the application, background check and other verifications as required by hospital policy.

When the application has been deemed complete, it will be submitted to the appropriate Department Chair for review and then will be forwarded to the Medical Staff Credentials Committee, the Medical Executive Committee, the Board Credentials Committee, and the Board of Directors. This process normally takes approximately three to four weeks. Please note that temporary privileges are not issued except in extremely rare instances.

Please contact the Medical Staff Office for any additional information or questions.

You must submit a written request to the Medical Staff Office. Your request will be forwarded to the Medical Staff Credentials Committee, Medical Executive Committee, the Board Credentials Committee and the Board of Directors.

To request additional privileges, please contact the Medical Staff Office for the appropriate form. The completed form and required documentation must be reviewed with your Department Chair and a signature obtained. The completed form should then be presented to the Medical Staff Office. The Request will be forwarded to the Medical Staff Credentials Committee, Medical Executive Committee, the Board Credentials Committee and the Board of Directors.

Requests for deletion of privileges must be made in writing to the Medical Staff Office. Requests will be forwarded to the Medical Staff Credentials Committee, Medical Executive Committee, the Board Credentials Committee and the Board of Directors.

Please refer to Article VII, Part C, Section 5 of the Medical Staff Bylaws, Rules and Regulations.

Please notify the Medical Staff Office of all changes in your office or home addresses, contact numbers or e-mail addresses.