Credentialing & Privileging

Application Request Forms

Select the appropriate request that meets your situation:

• Initial Appointment at one or more Mon Health System hospital(s)
• Employed or contracted Physician or APP 
• Independent Physician or APP 
• Locum Tenens Physician or APP 
• For additional information on Locum Tenens requirements, please review the Screening Checklist.
• Activation at additional Mon Health System hospital
• Additional privileges for existing appointment

All requests are processed in 1-2 business days. After your request has been processed, you will receive an email with your MD-Staff access information. A credentialing specialist will assist you with the credentialing application process, including access to MD-APP.

To view the Mon Health Medical Staff & Advanced Practice Provider category definitions, click here.

Reappointments

If you are a new medical staff or APP applicant and submitting your credentialing application for the first time, please visit the new applicants page for further information.

Appointments are typically valid for two years (24 months).

You will receive an email notifying you of reappointment tasks and PHP account information approximately six (6) months prior to your reappointment application deadline. In order to ensure timely processing, please complete your reappointment application promptly.

You are always welcome to contact your credentialing specialist if you have questions regarding your reappointment or need assistance accessing your application.