Credentialing Process for Membership and Privileges
Each facility receives and verifies initial applications. If you wish to
apply for both Santa Rosa Memorial Hospital and Petaluma Valley Hospital,
please indicate on your request for application so that we may process
using the same application at both facilities.
Application Process for Physicians, Dentists, Podiatrists, Psychologists,
Advanced Practice Nurses, and Certified Physician Assistants:
1. Request an application using the attached
Application Request form.
2. Applications are provided on-line for those who meet the minimum criteria
for each facility
- Graduate of an approved medical, osteopathic, dental, podiatry or nursing
school, or hold the appropriate degree
- Licensed to practice in the state of California (or in the process of obtaining
- Board certification in their primary practicing specialty, or within five
years of completion of training and meet the requirements for board certification
- Have both a residence and practice location within the hospital’s
primary service area (unless practicing telemedicine or as a locum tenens)
- Are able to provide documentation of current clinical competence for the
privileges to be requested
3. The Medical Staff Services office processes applications and verifies
information within 45-60 days of receipt.
Coordinators contact applicants as needed to ensure complete verification and receipt
of required documentation.
4. Credentialing Coordinators then follow and track the privileging process
after verifications are complete. Each facility has a specific privileging process.
5. Department Chairs, Medical Staff Committees, and the Board of Trustees
at each entity will review applications upon completion of the verification process.
Application Process for Clincal Assistants
Medical Staff Services screens applicants for Clinical Assistants (Audiologists,
Clinical Research Assistants (RN), Clinical Neurophysiologic Intraoperative
Monitoring Technicians, Clinical Perfusionists, Physicists, Registered
Dental Assistants, Registered Nurses (Surgical Services), Registered Nurse
First Assists) and Surgical Technicians. For additional information, please contact
Medical Staff Services.