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Medical Staff Services


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


Delineation of Privileges Forms

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

Advanced Practice Providers


Department of Medicine


Department of Pediatrics


Department of Radiology


Division of Specialty Services


How To Submit Your Application

Email your completed reappointment documents to your assigned Credentialing Coordinator as noted. Reappointments are processed according to your month of birth:

  • Angela Guillory is processing reappointments with a last name beginning with A through K.
  • Roseann Rodriguez is processing reappointments with a last name beginning with L through Z.


Emailing within the NJH system is secure. Please use the following secure file drop If emailing from a non-NJH address: