Doctor Application

Completion of Trinity Hospital's Medical Staff Pre-Application Form is required prior to an interview. Completion of the Medical Staff Pre-Application Form in no way obligates the hospital and/or medical staff to grant medical staff membership or privileges.

Pre-Application Form Instructions

This pre-application form cannot be submitted online. The pre-application form (hard copy) must be returned with the following documents:

• Current license to practice medicine in state of current medical practice.
• Current Federal DEA Registration certificate.
• Certificate of professional liability insurance coverage
• ECFMG certificate (if foreign medical graduate)
• Medical Diploma
• Internship/Residency/Fellowship certificates
• Evidence of board certification status
• A complete curriculum vitae
• Evidence of tuberculin skin test or chest x-ray (must be within the last 12 months).Evidence has to be provided prior to the first day of employment and/or granting or privileges.

For more information, please contact Shar Grigsby at (701) 857-7860.

Download the Medical Staff Pre-Application Form

Trinity Health is committed to equal employment opportunity for all persons. It will not discriminate because of race, color, creed, religion national origin, sex, sexual orientation, disability, age, marital status or status with regard to public assistance. Trinity Health is committed to utilizing employment practices that protect individuals from illegal discrimination. The responsibility for implementing these policies is upon the Personnel Department of Trinity Health. Individuals with questions or grievances regarding Trinity Health's policies or procedures should seek assistance from the Personnel Department. It is the policy of Trinity Health to provide Equal Employment Opportunity to all qualified disabled veterans, individuals with disabilities, and Vietnam era veterans who are employees or applicants for employment.