Medical Staff Services

Reappointments

All documents required for your NJH reappointment are available on this webpage. We require the following four items for your reappointment:

• Colorado Health Care Professional Credentials Application
• Consent & Release form
• Delineation of Privileges form for your practice specialty
• CME credits for the last two years

Please download the Colorado Health Care Professional Credentials Application, Consent Form, and applicable Delineation Form from the links below, complete, and return along with your CME credits to the Credentialing Coordinator noted in the reappointment email you received. Every form is set up so you can complete and electronically sign them using PDF software. Authenticated digital signatures are required on all forms (applied using a password through PDF software). We also accept wet signatures. We cannot accept typed-in or stamped signatures.

Application Forms

• Colorado Health Care Professional Credentials Application Prepopulated for NJH Employed Providers
• Colorado Health Care Professional Credentials Application for Non-Employed Providers
• Consent & Release Form

Delineation of Privileges Forms

   **Use the form that matches your NJH practice department and specialty

Advanced Practice Providers

• Advanced Practice Providers (all departments and specialty areas except CRNAs)
• Certified Registered Nurse Anesthetists

Department of Medicine