Med Staff

Forms

Allied Health Professionals Application

Medical Staff Applications

Privileges

Documents

Committees

Services

STEP 1

• The Department Contact authorizes Medical Staff Services to send a medical staff application.  Applications are sent electronically.  Please Verify that the Contact Has Your Correct E-mail Address.

STEP 2

• Medical Staff Administration Will Send You 2 Separate E-Mail Notices (one with the link to the web-site and one with your password).

STEP 3

• Download the Application Packet & Follow Instructions.  You can click the Save button to save your work and return later.  IMPORTANT: Print a Copy of Your Completed Application.  A paper copy with signatures is required to complete the process.

STEP 4

• Privilege Form(s) will be sent to you by a separate e-mail.  Print the form(s).  Complete the form(s), sign and submit with your completed application.  Additional documentation may be required for privileges.

STEP 5

• Completed Applications Will Be Transmitted Electronically when you click the Submit button to Medical Staff Administration; however, a signed paper copy is required to complete the process.

STEP 6

• Make your check out to "UC Regents."  Fees are not refundable.  Submit Your Completed and Signed Application and Privilege Form(s) With Supporting Documentation to:

MEDICAL STAFF ADMINISTRATON

200 W. Arbor Drive, #8821

San Diego, CA 92103-8821

QUESTIONS

1. Medical Staff Administration Main Line - (619) 543-7874
2. New Applicants & Allied Health Professionals - (619) 543-7833
3. Reappointment - (619) 543-7811