NEW MEXICO STATEWIDE APPLICATION, PRIVILEGES AND FORMS
Welcome to HSC’s on-line application and document download services.
For help on how to use HSC's on-line services, or for more information regarding DOI Regulation NMAC13.10.21.9, click here.
The application may be used for initial appointments and reappointments.
On-Line Version
Word Version
PDF Version
PRIVILEGES AND FORMS
Locate the organization(s) to which you are applying from the list below and download the appropriate privilege forms, by-laws and other documents.
New Mexico Organizations
- Advanced Care Hospital of Southern New Mexico
- Alamo Navajo Medical Center: No additional documents necessary.
- Albuquerque Health Care for the Homeless: No additional documents necessary.
- Artesia General Hospital
- Ben Archer Community Health Centers: No additional documents necessary.
- Cibola General Hospital
- DeBaca Clinic: No additional documents necessary.
- El Centro Family Health: No additional documents necessary.
- Endoscopy Center: No additional documents necessary.
- Epidemiology and Response Division (DOH): No additional documents necessary.
- First Choice Community Healthcare
- Fort Bayard Medical Center (DOH)
- Gila Regional Medical Center: No additional documents necessary.
- HealthSouth Rehabilitation Hospital
- Hidalgo Medical Services: No additional documents necessary.
- Holy Cross Hospital
- Jemez Health and Human Services: No additional documents necessary.
- La Casa De Buena Salud: No additional documents necessary.
- La Clinica De Familia, Inc.
- La Familia Medical Center: No additional documents necessary.
- La Vida Health Services Organization: No additional documents necessary.
- Las Clinicas Del Norte
- Los Alamos Medical Center
- Memorial Medical Center
- Mesilla Valley Hospital
- Miners' Colfax Medical Center
- New Mexico Behavioral Health Institute at Las Vegas: No additional documents necessary.
- New Mexico Orthopaedic Surgery Center
- New Mexico Rehabilitation Center (DOH): No additional documents necessary.
- New Mexico Veteran's Center (DOH)
- Nor-Lea General Hospital
- Peak Psychiatric Hospital: No additional documents necessary.
- Pecos Valley Medical Center: No additional documents necessary.
- Physicians Plaza Surgery Center
- Presbyterian Health Plan
- Presbyterian Medical Services
- Public Health Division: No additional documents necessary.
- Pueblo of Isleta Health Center: No additional documents necessary.
- Pueblo of Sandia Health Center: No additional documents necessary.
- Pueblo of San Felipe: No additional documents necessary.
- Rehabilitation Hospital of Southern New Mexico
- Rehoboth McKinley Christian Hospital
- Santo Domingo Health Center: No additional documents necessary.
- Sierra Vista Hospital
- Specialty Hospital of Albuquerque
- Turquoise Lodge Hospital (DOH)
- Union County General Hospital
- Villa Therese Catholic Clinic: No additional documents necessary.
HELP
You can now access all of the documents necessary for the credentials verification process. Follow the step-by-step instructions to enter your application on-line or download and print the appropriate documents, then complete, sign and mail them to us promptly so that we can process your application for appointment. Submitting the application on-line will allow you to prepopulate your information.
Instructions
All three steps must be completed regardless of whether you choose to submit your application on-line or download it.
Step One: The New Mexico Statewide Application may be submitted on-line or downloaded.
Step Two: Locate the organization(s) to which you are applying from the list above and download the appropriate privilege forms, bylaws and other documents. If you select a facility and find that "no additional documents are necessary," you may proceed to step three. Questions can be directed to 505-343-0070.
Notice: These additional documents are Adobe PDF files and should be viewed with Adobe Acrobat Reader. If you do not currently have the Acrobat Reader on your system, you can download a free copy.
Step Three: Return the application and release and all other completed and signed documents to HSC within fifteen days from the date of our letter to you.
Hospital Services Corporation
P. O. Box 92200
Albuquerque, NM 87199-2200
Facsimile: (505) 346-0288
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