Skip Navigation

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