My Locker

Onboarding Information

Please complete all relevant forms below and submit all sections accurately to ensure proper credentialing and placement.

If you are qualified in multiple specialties, a separate checklist must be completed for each area of practice.

Need help? Our credentialing team is just a message away at credentialing@hpahealthcare.com

Medical Education

Medical Education - Physician

Medical Education - CRNA, Nurse, Nurse Practitioner, Physician Assistant

Licences and Certifications

License & Certifications

Professional References

Professional References

Practice Affiliations

Practice Affilliations

Risk Management

Risk Management

Skills Checklists

RN Skills Checklists are completed through Relias and will be emailed to you separately.

Anesthesiology & Critical Care Physician

Cardiology Physician

Certified Registered Nurse Anesthetist (CRNA)

Emergency Medicine Physician

Family Medicine Physician

Gastroenterology Physician

Hospitalist Physician

Nurse Practitioner

OB/GYN Physician

Orthopedic Surgery Physician

Pediatrics Physician

Psychiatry Physician

Pulmonary & Critical Care Physician

Radiology Physician

Surgery Physician

Surgery Trauma CC Surgeon

Urology Physician

Supporting Documents

You can submit up to 3 documents at a time by clicking on the Upload Document buttons below.

Accepted File Types: PDF, JPEG, PNG, GIF, and DOCX. Max file size: 1.5 MB.

This field is for validation purposes and should be left unchanged.
This field is hidden when viewing the form
This field is hidden when viewing the form
This field is hidden when viewing the form
This field is hidden when viewing the form
MM slash DD slash YYYY
Max. file size: 128 MB.
Max. file size: 128 MB.
Max. file size: 128 MB.