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Visitor Guideline Update: Due to respiratory virus season, children 12 and under are not permitted to visit patients in multiple settings. Additionally, everyone is required to mask in patient rooms and other designated areas. Learn more.

After Medical Staff Services has received your Provider Information Form you will receive an email from the Intake Coordinator requesting that you complete the Pre-Application. You will need to enter the email address provided in the email, then click “First Time Login”. An email will be sent to you with a link. Follow the directions in the email to create your password. Please save this password, you will need it to complete your full medical staff application at a later date. Once completed, sign electronically and submit within 1 business day.

SPECIAL NOTE: Upon our review of your pre-application and it is determined you meet eligibility, you will be sent a second email with a link to your medical staff application.

Step 1: Log in to the Application Module 

  • Select "Save & Continue" throughout the process.
  • Check all information carefully for completeness and accuracy. Your application may be pre-populated with information you have provided to us through an initial or reappointment application.

Step 2: Please complete all information within the apps section. **Complete all questions.

  • Apps -> Atrium Health Tab - Edit each field on the left-hand side
  • Health Status - input your TB and Flu (documentation required)
  • Answer all Questions
  • Click "Review Information"
  • Go to "Sign Documents"
  • "Click to Sign"  to open each document
  • TYPE IN YOUR FULL NAME at the bottom of the document
  • Click "Sign Application"
  • Click "SUBMIT" once all documents are signed