Application Documents



HSC/LAC Documents



HSC/LAC Application Form
HSC/LAC Authorization, Attestation and Release Form
HSC/LAC Professional Practice Questions
HSC/LAC CME Form
HSC/LAC References List
Disclosures and Definitions

California Documents



California Participating Physician Initial Application Form in Word Format
California Participating Physician Initial Application Form in PDF Format
California Participating Physician Initial Application Form - Professional Practice Questions
California Participating Physician Initial Application Form - Release and Attestation

California Participating Physician Reappointment Application Form in Word Format
California Participating Physician Reappointment Application Form in PDF Format
California Participating Physician Reappointment Application Form - Professional Practice Questions
California Participating Physician Reappointment Application Form - Release and Attestation

CPPA Addendum A
CPPA Addendum B

Colorado Documents



Colorado Application Form
Colorado Application - Attestation
Colorado Application - Professional Practice Questions
Colorado Application - Release

Louisiana Documents



Louisiana Standardized Credentialing Application
Louisiana Standardized Credentialing Application - Professional Practice Questions
Louisiana Standardized Credentialing Application - Release and Attestation

Texas Documents



Texoma Application Packet And Additional Forms

A complete listing of the Texas Standardized Application can be accessed here. We recommend that you access the credentialing forms using this link to ensure that you are using the most current copy of the available forms.