Medical Staff Application

To complete the application you will need to access the link below. You will need to enter your email address. If you have not previously created a password you will need to select “First Time Login” to create one. Due to the time-sensitivity of this information and levels of approval, it is imperative that you submit your application, along with all supporting documents, within 5 days to avoid potential delays in your scheduled start date. If we do not receive the application and all supporting documents within 10 days, your packet is considered incomplete and a new start date will be requested.

Step 1: OPEN AND REVIEW - Mandatory - Medical Staff Education PowerPoint

  • Please open and read the attached slides relating to Medical Education for EMTALA, Emergency Management, Corporate Privacy and Pain Assessment and Management. **Please note you will be signing an attestation in your application documents indicating you reviwed this PowerPoint.
  • Access the Documentation Library to review any addtional education modules that you will need to complete the application process.

Step 2: Log in to the Application Module 

  • Select "Save & Continue" throughout the process.
  • Check all information carefully for completeness and accuracy. Your application may be pre-populated with information you have provided to us through an initial or reappointment application.

Step 3: Please complete all information within the apps section. **Complete all questions.

  • Apps -> Carolinas HealthCare System Tab -  Edit each field on the left-hand side
  • Health Status - input your TB and Flu (documentation required)
  • Answer all Questions
  • Click "Review Information"
  • Go to "Sign Documents"
  • "Click to Sign"  to open each document
  • TYPE IN YOUR FULL NAME at the bottom of the document
  • Click "Sign Application"
  • Click "SUBMIT" once all documents are signed

Professional Photo: Please provide a professional photo as this photo will be displayed on the CHS Physician Connect webpage.

Tip for Completing Education, Affiliations, and Work History Accurately:

  • If the item is not found, choose "INSTITUTION NOT PRESENT" and type the institution name in the Comments Section at the bottom of the page.

To receive real-time updates on your status please visit:

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