Credentialing

Thank you for your interest in applying to the John C. Lincoln Health Network. Here you will find information about steps required to gain credentials at John C. Lincoln Hospitals.

To expedite the credentialing process, and for your convenience, John C. Lincoln Health Network is now processing all initial applications in house. Please follow the steps below to initiate the application process. The PDF documents available for download on this page require free Acrobat Reader software.

Note: If you are already on staff at one of the John C. Lincoln Hospitals and wish to apply at the other facility, please complete the Internal Application Request Form (PDF) and either fax it to 623-434-6106 (or 623-434-6107) or email it to the Credentialing office. Once the request is received, a pre-populated application will be sent to you for your review.

If you have specific questions about the credentialing process, please call Network Credentialing Manager Sherry Sutherland at 623-434-6102 or email her.

Our network credentialing office coordinates the application process for North Mountain and Deer Valley Hospitals alike.

How to Apply

Step 1 - Minimum Qualifications: Before you begin your application process, please download and review the minimum qualifications for the hospital, or hospitals, to which you're applying:

• Deer Valley Hospital Minimum Qualifications (PDF)
• North Mountain Hospital Minimum Qualifications (PDF)

Step 2 - Initial Application: Once you've met the minimum qualifications, download and complete the appropriate initial application:

• Initial Application for Physicians (PDF)
• Initial Application for Allied Health Professionals (PDF)

Step 3 - Delineation of Privileges: Print and complete the Delineation of Privileges checklist that pertains to your specialty — as well as the Conscious Sedation Form — for one, or both, hospitals:

• Deer Valley Hospital: Physicians
• Deer Valley Hospital: Allied Health
• Conscious Sedation Form and Quiz for Initial Appointment and Reappointment (PDF)

• North Mountain Hospital: Physicians
• North Mountain Hospital: Allied Health
• North Mountain Hospital Conscious Sedation Form and Quiz for Initial Appointment and Reappointment (PDF)

Step 4 - Professional Information: Obtain copies of the following documents:

• Curriculum Vitae
• Malpractice insurance face sheet ($1 million $3 million minimum with approved carrier)
• Residency / fellowship logs (if completed within the last five years)
• Board Certification Certificate or Letter from the Board stating you have been accepted to take the Boards
• Current copy of BLS/ACLS/NRP (etc.)

Step 5 - Submit application: Please submit all documents specified in steps 2, 3 and 4 to:

John C. Lincoln Health Network
Attn: Credentialing Office
2500 W. Utopia Rd. #100
Phoenix, AZ 85027

Step 6 – Schedule your JCL Connect Training (Electronic Medical Record):

Note: Approval of privileges will not be granted until the JCL Connect training has been completed.

Once we receive your completed application materials, we will review the application and start the verification process. The verification process and Medical Staff approval process can take up to 90 days. Please note that submitting an incomplete application will cause a delay in the processing of your application.

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