Credentialing Services
- Participating Provider Application
- Rules & Regulations
- Bylaws Table of Contents
- Bylaws
- Psychology Privilege Form
- Psychiatry Privilege Form
- Associate Physician Privilege Form
- Non-Psychiatry Physician Privilege Form
- Consulting and Associate Physician Privilege Form
- UNI HOME APRN Privilege Form
- UNI HOME Non-Psychiatry APRN Privilege Form
- UNI HOME LCSW Privilege Form
- UNI HOME Psychology Privilege Form
- UNI HOME Psychiatry Privilege Form
- UNI HOME Non-Psychiatry Physician Privilege Form
- UNI HOME Physician Assistant Privilege Form
- Fair Hearing Plan
For credentialing forms or information please contact:
Lynette Bertocchini
University Neuropsychiatric Institute
Medical Staff Office
650 Komas Drive, Ste 100
Salt Lake City, UT 84108
lynette.bertocchini@hsc.utah.edu
Phone (801) 587-6024
Fax (801) 585-1605

