Online Application Form


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Complete all details below to create your account. Once you have created your own account, you may now login to our website to begin your Pre-Application. To view the complete Process Flow of the Credentialing and Privileging in The Medical City, click HERE.


In compliance with the Data Privacy Act of 2012, The Medical City ensures that the information you provide will be kept strictly confidential and will only be processed, disclosed or shared upon your consent, or as required by law.


By creating your account, you AGREE to the use of the personal data you submitted.


NOTE: All required fields are marked with Red Asterisk (*)


ACCOUNT DETAILS
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