Practitioner Documents

Document Type	File Name
HSC/LAC	CME Form
HSC/LAC	Disclosures and Definitions.pdf
HSC/LAC	HSC Release and Attestation
HSC/LAC	HSC Release and Attestation - DocuSign Enabled Link
HSC/LAC	HSC/LAC Application Form
HSC/LAC	NMMB Applicant Oath
HSC/LAC	NMMB Instructions for All Applicants
HSC/LAC	NMMB Instructions If Applying Using HSC
HSC/LAC	NMMB Malpractice History Form
HSC/LAC	Professional Practice Questions
HSC/LAC	References List.docx
CA	California Initial Credentialing Application
CA	California Initial Credentialing Application PPQs
CA	California Initial Credentialing Application_Release and Attestation
CA	California Re-credentialing application.pdf
CA	California Re-credentialing Application_PPQs.pdf
CA	California_Initial_Credentialing_application_application.docx
CA	California_Re-credentialing_application.docx
CA	CPPA_Addendum_A.doc
CA	CPPA_Addendum_B.doc
LA	Louisiana Standardized Credentialing Application.pdf
LA	Louisiana Standardized Credentialing Application_PPQs.pdf
LA	Louisiana Standardized Credentialing Application_Release and Attestation.pdf
TX	Texas Standardized Credentialing Application
WA	Washington Practitioner Application and Release PDF version
WA	Washington Practitioner Application_Word version
WA	Washington Practitioner Release Form