Requesting an application for Medical Staff membership

Please contact the Medical Staff Office to request an application, referred to as a “Request for Consideration – RFC” for staff membership and clinical privileges for your specific specialty. Gabrielle Pepperman at (850) 747-7109 or via email.

Step 1

You will need to call or email Gabrielle Pepperman in order to start the credentialing process. She will then send a pre application to get some basic knowledge such as full legal name, social security number, and NPI number. When you return the pre application to Gabrielle Pepperman by fax, email, or in person she will submit this and you should receive the online application through your email within 48 hours. The application fee can be paid by check, please see more about application fees in the Frequently Asked Questions section. Application that do not include the application fee will not be processed until the fee has been received.

Step 2

Once you have received your application packet, read the Medical Staff Bylaws, HCA Code of Conduct, Mission, Vision and Values Statement. All applicants should thoroughly review these documents prior to requesting staff membership and/or clinical privileges. You will be asked to sign an attestation that you have read and fully understand and agree to comply with the Medical Staff Bylaws, Rules and Regulations, and applicable policies.

Step 3

Once you have fully completed the Request for Consideration, please submit the application online. This will send the paperwork directly to the Parallon Credentialing Processing Center in Jacksonville, Florida. Please send any supplemental documents to Gabrielle Pepperman in the Medical Staff Office. Also keep a copy for your records.

By accepting and completing a Request for Consideration and returning it with the $500 dollar application fee, you acknowledged that you have reviewed and understand the Medical Staff Bylaws, Rules and Regulations, and Code of Conduct. You further agree to be bound by the same, both at the time of application and throughout your appointment and reappointment terms. You are strongly urged to print these documents for future reference and be familar with them.

Credentialing Portal

FAQ for Medical Staff applicants

Medical doctors (MD’s and DO’s), podiatrists (DPM) and dentists (DDS and DMD). All others (such as nurse practitioners, physician assistants, CRNA’s, and anesthesia assistants, etc) are considered advanced practice professionals (APPs) and may not apply for membership to the medical staff. However, they may apply for privileges, provided that they meet the criteria set forth in the Medical Staff Bylaws.
No. The fee for Medical Staff applicants is $500 and the fee for all Advanced Practice Professionals is $75. Applicants who plan to join an existing group may be able to make arrangements within that group for payment, but please understand that the Medical Staff Office does not coordinate such arrangements, and the applicant is ultimately responsible for the payment. Payment must be received before any processing will begin. The application fee is non-refundable, so if for any reason your application is denied or you withdraw your application after paying the fee, you will not be entitled to a refund.
The application and attachments will be acknowledged by email, letter, and/or phone. (If you have not received an acknowledgement from Parallon within one week, please contact the Medical Staff Office.) The materials will be thoroughly reviewed and processed. This includes review and verification of credentials, training, references, current and prior affiliations, other information in the application, and other checks and verifications as required by hospital policy. Once all credentialing functions have been completed, your file will be presented to the appropriate Department Chief for review and recommendation. His/her recommendation is brought before the Credentials Committee and the Medical Executive Committee for review and recommendation. The Medical Executive Committee will make a recommendation to the hospital’s Board of Trustees. The Board makes the final credentialing decision, which will be promptly communicated to you and after your initial orientation. You may then begin exercising your approved privileges at the hospital. The review and approval process can take 30 days.
The credentialing process is a joint effort of the Parallon Credentialing Processing Center, the hospital, and the current medical staff committees. We are proud to have a rigorous review process in place. This is for the protection of our patients, our medical staff, and our hospital. You can well understand the need for thoroughness in this very important process. The general timeframe for the entire process is generally around 8-12 weeks, from the time the application is received until final board approval is given. It is prudent to keep this in mind as you consider starting your practice, in relation to when the approval process is completed. Please understand that delays can occur for a number of reasons. The more complete and accurate your application is, the quicker the approval process.
If you should choose to withdraw your application after submitting it to the Medical Staff Office, written notice must be given. The application fee will not be refunded.
There are no membership or reappointment dues to pay once you are on staff. However, the Bylaws require active staff members to attend at least 50% of quarterly medical staff meetings and 50% of their respective department meetings.
The orientation package you receive at the time of appointment contains a lot of valuable information, along with the Medical Staff Bylaws. The Medical Staff Office is pleased to assist you with questions you may have about staff membership, the hospital, and the community. We may not have the answers you need, but most of the time we can direct you to a resource that can help. If your questions deal with clinical matters, you may wish to speak to the Chief of your Department or the Chief of Staff.

Contact us

If you have any questions or concerns regarding physician credentialing, please contact our Medical Staff Office.

Gabrielle Pepperman
Director, Medical Staff Services

(850) 747-7109

Email Gabrielle Pepperman

Sherry Stephens, RN
Coordinator, Medical Staff Services

(850) 747-7789

Email Sherry Stephens