Welcome new providers!
All documents required for your NJH application are available on this webpage. Please click each document as applicable to your planned NJH practice, download/save to your computer, complete, and return to your assigned Credentialing Coordinator noted at the bottom of this page.
All documents are set up so you can complete and electronically sign using PDF software, except the Signature Authentication Form, which must be printed and completed by hand. Authenticated digital signatures are required on all other forms requiring such (applied using a password through PDF software). We also accept wet signatures. We cannot accept typed-in or stamped signatures.
Checklists (informational only)
Application Forms (all three are required)
Delineation of Privileges Forms
**Use the form that matches the department and specialty for your NJH practice
Advanced Practice Providers
Department of Medicine
Department of Pediatrics
Department of Radiology
Division of Specialty Services
Malpractice Insurance Documents
NJH Bio Sketch
This form must be completed electronically, meaning please type your information directly into the form you choose, and then submit it to us in an editable format.
Use whichever version you prefer. You do not need to complete both versions.
How To Submit Your Application
All new providers outside of NJH should use this secure link to submit their application: