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

See requirement details below:

Online Application & Privilege form (s)

  • Submission of actual CME hours are not required.  However, a question on the online application will ask you to attest that you have completed the hours required to maintain your medical license, along with a brief listing of the activities.  It is also not necessary to record CME hours if you recently completed a Residency or Fellowship. 

Please indicate on the CME question on the online application:

“I recently completed/will complete a Residency/Fellowship program."

  • 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.
  • Category-A Core Privileges are generally privileges that 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 advanced 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.
  • 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

UCLA Health requires healthcare providers to complete a number of Training Modules at the time of initial appointment and reappointment. 

Initial Applicants: Select each training module link below to begin the training:

*For technical support questions pertaining to your education and training modules, please contact the following by email:

HR Help Desk: [email protected]

Reappointments: Required Trainings will be loaded to Cornerstone for you. Please contact your Medical Staff Liaison if you have questions. 

*For providers who are applying/reapplying for Venice Family Clinic ONLY, and do not have any other UCLA Health Hospital appointments, ONLY the HIPAA Training Module is required. 

*If you believe you have recently completed the modules (within the past 12 months), please contact your Medical Staff Liaison  or upload directly onto the online application.  *Your results may not have been registered in the HR system accessed to verify completion of training modules.

  • Initial applicants: If you are requesting moderate sedation privileges for the first time, follow this LINK to take a moderate sedation quiz.  
    • A certificate of completion is required to be granted this privilege.  
    • Please email your Medical Staff Liaison with your quiz completion certificate and to obtain additional criteria for approval.

  • Reappointments: For providers undergoing reappointment, documentation of moderate & deep sedation cases OR a certificate of completion of the aforementioned quiz is required for renewal. 
  • If you elect to submit cases rather than take the quiz, please contact your Medical Staff Liaison if you have questions. 
  • Moderate Sedation: 4 cases OR quiz required
  • Deep Sedation: 4 cases required 

Deep Sedation:  In order to be eligible for deep sedation privileges, physicians must successfully meet the requirements for moderate sedation plus both of the following:

1.     Attend a meeting with a member of the Anesthesiology Department who reviews the candidate's intended drug protocol(s) and the UCLA hospital policy's requirements for deep sedation. 

2.      Document  successful airway management (positive pressure ventilation via mask) during 3 general anesthetics.  This requirement will be proctored and supervised by a member of the Anesthesiology Department, and the proctoring form sent to the Medical Staff Office.

Alternatively, physicians in the following disciplines, by virtue of their training and experience, are eligible for privileges in deep sedation upon the recommendation of their Clinical Service Chairs:

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

Moderate & Deep Sedation Case Forms:

Please email your Medical Staff Liaison  for the password to access the forms below.




  • 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.

**NEW PROCESS - Effective: August 21, 2023**

  1. ALL applicants are required to complete the TB Questionnaire. 

  2. ONLY applicants with risk factors for tuberculosis (TB) will be required to test. (*OH will contact you directly if testing is needed)

Steps to complete TB Questionnaire:

  1. Log into UCLA Health MyChart account
  2. Complete TB Questionnaire 
    1. My Chart Filepath:  Menu > My Record > Questionnaires > TB Assessment
  3. OHF will notify you directly if a new blood draw is required



  • All members of the Medical Staff and Allied Health Professional Staff must demonstrate compliance with the UC-wide COVID-19 Vaccination policy, requiring full vaccination against COVID-19.

Practitioner Specific Requirements

  • 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.

  • Physician Assistant Practice Agreement at appointment/reappointment
  • Job Description (Initial)
  • Performance Evaluation (Reappointment)

Coming Soon...

Additional Support

  •  A confirmation email will be sent to you upon submission of your online application. However, submission of your online application does not constitute completion of the credentialing process.
  • The entire application process is complete when your online application has been submitted AND all additional requirements (TB Questionnaire, Training Modules) noted above have been completed

    For further confirmation, email [email protected]

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

To ensure all appointment/reappointment requirements are complete,

Please review our checklist: 

Appointment/Reappointment Requirements Checklist