Provider Application Process

The Medical Staff Office is pleased to announce the release of the Practitioner Portal, a user-friendly interface for completing electronic credentialing applications and privilege request forms. With this transition to this new online application portal, the medical staff office has begun utilizing the Trinity Health central verification office (The Center for Practitioner Information) to collect primary source verifications for our credentialing files. We will remain your main point of contact for all matters related to credentialing and privileging.

If you are interested in applying for privileges at Saint Agnes, please click "Apply Now" at the bottom of this page to access the fillable PDF application. Once complete, email the form to our Medical Staff Office at SAMCMedicalStaff@samc.com.

Once received, the Medical Staff Office will forward the request to the Central Verification Office and you will receive a link to begin the online application process.

If you have any questions regarding this or any other process, please contact the Medical Staff Office at (559) 450-3631.

Apply for hospital privileges

Interested in joining our medical staff? Click the 'Apply Now' button to download and fill out the application form. Email the completed form to our Medical Staff Office at SAMCMedicalStaff@samc.com. 

Apply Now