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 complete the PDF form below and send it directly to the Medical Staff Office email 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 there are any questions regarding this or any other process, please contact the Medical Staff Office at (559) 450-3631.