Applications must be completed and submitted within 30 days of receiving initial link when provider applies for privileges. 

Application fee required with re-appointment application.

Fee-$200 Physician

Fee-$100 Allied Health/Advanced Practice Professional

PLEASE NOTE THE FOLLOWING:

Workstation requirements for Practitioner Home Page use:

1. Microsoft Internet Explorer Web Browser versions 6-10 or Safari version 5.0 or higher
2. Screen resolution 1024 x 768 pixels or higher
3. Adobe Reader 7.0 or higher

Users of Safari before 5.0, Firefox, Netscape, AOL, Opera, or other unusual environments such as Linux or VMWare may still encounter problems, and should instead use a workstation equipped with supported software meeting the requirements described above.

Please note that a recent update to Google Chrome, version 37.0.2062.124, has resulted in Chrome displaying the message "Undefined" when submitting a form using Chrome when any required fields on the form need to be filled. If you encounter this message, please carefully review the form and complete any required fields.

Additionally, for this reason, using a computer with IE 9 to complete the forms would be best.

Documents required to begin with re-appointment application process:

1. Application Form  (contact Medical Staff Services to obtain application fmhmedstaff@foundationhealth.org) 
2. Privilege Form(s)
3. Consent Form
4. Pre-Check Release Form