Get Credentialing Criteria Stand-alone Privileges I. Criteria ... - Cabellhuntington

Filling out the CREDENTIALING CRITERIA form is an essential process for individuals seeking stand-alone privileges in a healthcare setting. This guide will provide you with clear and comprehensive steps to complete the form accurately, ensuring a smooth application process.

Follow the steps to complete the form accurately and efficiently.

1. Begin by locating the form online and select the ‘Get Form’ button to access the document for completion.
2. Carefully review Section I, CRITERIA FOR APPLICATION, where you need to provide a written statement of need, ensuring it is signed by your employer or supervisor.
3. Prepare to upload or submit a copy of your current license or certification, if it applies to your profession.
4. Provide documentation verifying your malpractice coverage, if applicable, to confirm your professional liability insurance.
5. Ensure that you include your current West Virginia State licensure for Speech-Language Pathology as part of your documentation.
6. Include proof of a negative TB skin test or chest x-ray taken within the past year, as this is a mandatory health requirement.
7. Once all sections are filled, review for completeness and accuracy, then save the document. You can choose to download, print, or share the completed form as needed.

Complete your credentialing application online to ensure you receive the requested privileges.