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For Credentialing Staff Use OnlySpecialty___ Date Application Received___Attach a recent 2 × 2 passport size photograph for the master file and each facility marked on thisapplicationDate Application
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For credentialing staff use, staff members are required to submit their qualifications, experience, and other relevant information to be reviewed and verified.
All staff members who are involved in providing services or care must file for credentialing staff use.
To fill out for credentialing staff use, staff members need to complete the required forms, provide necessary documentation, and submit everything for review.
The purpose of for credentialing staff use is to ensure that all staff members meet the necessary qualifications and standards to provide safe and effective care.
Information such as education, training, licenses, certifications, work history, and references must be reported on for credentialing staff use.
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