Medical & Professional Staff Administration

Appointment/ Reappointment Requirements

Appointment & Reappointment Requirements

*ALL items must be completed for your credentialing application to be considered complete. 

See requirement details below:

Online Application & Privilege form (s)

1. Continuing Medical Education (CME)
  • Submission of actual CME hours is not required.
  • The online application includes an attestation confirming that you have completed the CME hours required to maintain your medical license, along with a brief description of CME activities.
  • If you have recently completed or will complete a Residency or Fellowship, you are not required to report CME hours or activities.
    Please select the following response in the CME section of the application: “I recently completed / will complete a Residency or Fellowship program.”
2. Privilege Form (RR, SMH & NPH)
  • You will request or re-request specific procedural privileges for your department as part of the online application.
  • If you believe the incorrect privilege form was included on the online application, reach out to your Medical Staff Liaison or your Department Chair for more information.

For members already On-Staff, you may view your current privileges HERE.

3. Privilege Categories (RR, SMH & NPH)
  • Category A (Core Privileges):
    Generally require completion of a Residency only.
  • Category B and C Privileges:
    Generally require advanced training, such as an ACGME‑accredited Fellowship, board certification, or other specialized training.

Should you need more assistance completing your privilege form, contact your Medical Staff Liaison.

For members already On-Staff, you may view your current privileges HERE.

4. Santa Monica Back-Up Coverage Form (SMH ONLY)
  • You will be asked to list a covering physician on the Santa Monica Backup Coverage Form.
    • The covering physician is usually a colleague who is willing to provide backup coverage for you.
    • Please contact the UCLA Health Santa Monica Medical Staff Office at (424) 259-9531 should you have a question regarding whom to list.

Additional Requirements

5. Training Modules

UCLA Health requires healthcare providers to complete designated training modules at the time of initial appointment and reappointment, as applicable.


Initial Appointment

All initial applicants must complete all required training modules listed below at the time of appointment.
Select each training module link to begin the training.

Required Modules:

* Access Requirement: An Active Directory (AD) account is required to access modules marked with an asterisk (*). New applicants may complete these modules after an AD account has been issued.

Technical Support:
For questions related to education or training module access, please contact the HR Help Desk at [email protected] 


Reappointment

For reappointment, required training modules will be automatically assigned in Cornerstone.

If you have questions regarding assigned trainings or completion status, please contact your Medical Staff Liaison.


Special Circumstances

  • Venice Family Clinic Only:
    Providers applying or reapplying exclusively to Venice Family Clinic, with no other UCLA Health hospital appointments, are required to complete HIPAA training only.
  • Previously Completed Training:
    If you believe you have completed required modules within the past 12 months, please contact your Medical Staff Liaison or upload documentation directly into the online application.
    Training completion may not always be reflected in the HR system used to verify module completion.
6. Moderate & Deep Sedation Privileges (if applicable)

Initial Appointment

Applicants requesting moderate sedation privileges for the first time must:

Your Medical Staff Liaison will provide any additional approval requirements, if applicable.


Reappointment

Providers renewing moderate and/or deep sedation privileges must submit the following:

Moderate Sedation

  • Four (4) moderate sedation cases, or
  • Moderate Sedation Quiz certificate

Deep Sedation

  • Four (4) deep sedation cases
  • Must also meet all moderate sedation requirements, plus both of the following:
    • Meet with a member of the Department of Anesthesiology to review intended drug protocols and UCLA Health deep sedation policies
    • Document successful airway management (positive pressure ventilation via mask) during three (3) general anesthetics, proctored by Anesthesiology

Providers submitting cases instead of the quiz should contact their Medical Staff Liaison with questions.


Eligibility by Training and Experience

The following specialties may be eligible for deep sedation privileges based on training and experience, with Clinical Service Chair recommendation:

  • Emergency Medicine
  • Critical Care (Adult, Pediatric, Neonatology)
  • Pulmonary Medicine

Sedation Case Forms

To access Moderate and Deep Sedation Case / Clinical Activity Forms, please email your Medical Staff Liaison for the password:

 

7. Clinical Activity (Reappointments Only)
  • Members are expected to submit documentation and meet the criteria for requested privileges.
  • Please note: You are required to submit documentation of minimum clinical activity for your service area at the time of reappointment.  If you have any questions about the specific activity requirement, please contact your Medical Staff Liaison.
8. Provider Health Screening - TB Clearance

TB clearance is required for all UCLA Health hospital appointments.

All practitioners appointed to a UCLA Health hospital must submit documentation of TB clearance using one of the following:

  • QuantiFERON (QFT) Gold Test – completed within the past 12 months
  • PPD Skin Test – completed within the past 12 months
  • Chest X‑Ray – must show normal findings and be completed within the past 5 years

Initial Applicants:
TB clearance documentation must be submitted prior to your start date.


UCLA Faculty, Staff Physicians, and Non‑ACGME Fellows

Initial Appointment
Your department may arrange a health screening through UCLA Occupational Health (OH) at the time of appointment. Additional TB testing may be required based on screening results.

Reappointment
In place of the tests listed above, you may complete the annual TB Questionnaire by:

  1. Logging into your UCLA Health MyChart account
  2. Navigating to Menu > My Record > Questionnaires > TB Assessment
  3. Completing and submitting the questionnaire

Resources


Practitioner Specific Requirements

9. Job Description/Performance Evaluation (NPs, CRNAs, CNMs Only)
  • Nurse Practitioner (NP)
    • Job Description (Initial)
    • Performance Evaluation (Reappointment)
  • Certified Registered Nurse Anesthetist (CRNA)
    • Job Description (Initial)
    • Performance Evaluation (Reappointment)
  • Certified Nurse Midwife (CNM)
    • Job Description (Initial)
    • Performance Evaluation (Reappointment)

Please contact your department or immediate supervisor to obtain more information.

10. Physician Assistant Practice Agreement (Physician Assistants Only)
11. PhD

Coming Soon...


Additional Support

12. Questions

Email[email protected] 

Phone: (310) 794-0440 

or contact your Department Assigned Medical Staff Liaison

13. Confirmation of Application Status

You will receive a confirmation email after submitting your online application.
Submission alone does not indicate completion of the credentialing process.

Your application is considered complete only after:

  • The online application has been submitted, and
  • All required items noted above (e.g., TB Questionnaire, Training Modules) have been completed.

For additional confirmation or questions, please email [email protected] 

All requirements must be completed for your credentialing application to be reviewed.

14. Practitioner Checklist

To ensure all appointment/reappointment requirements are complete, please Review our Appointment/Reappointment Requirements Checklist