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

1. Graduate of an approved medical, osteopathic, dental, podiatry or nursing school, or hold the appropriate degree
2. Licensed to practice in the state of California (or in the process of obtaining licensure)
3. Board certification in their primary practicing specialty, or within five years of completion of training and meet the requirements for board certification (SRMH only)
4. Have both a residence and practice location within the hospital’s primary service area (unless practicing telemedicine or as a locum tenens)
5. 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.