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Privilege Request

Initial Application & Reappointment

Each medical staff application for appointment or reappointment must contain a request for specific privileges desired by the applicant. A request for privileges or a modification of privileges must be supported by documentation of training and/or experience.

  • Print the form(s). Sign and return the completed form(s) to Medical Staff Administration with your completed application.

Medical Staff Administration
200 W. Arbor, #8821
San Diego, CA 92103-8821

Request Privilege Mid-Cycle

Applicant must complete the Additional Privilege Request application - See Medical Staff Policy for additional information and process. Contact Medical Staff Services Administration at 619-543-7874.


  • Medical Staff Administration Main Line - 619-543-7874