Completion of Trinity Hospital's Medical Staff Pre-Application Form is required. 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.
Download the Medical Staff Pre-Application
Pre-Application Form Instructions
This pre-application form cannot be submitted online, but may be mailed or faxed. If faxed, follow-up with mailing the hard copy. The following are prerequisites for final approval of your privileges, but can be submitted with the pre-application, if available.
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)
Evidence of board certification status
A complete curriculum vitae
For More Information
For more information, please contact Shar Grigsby at (701) 857-7860 by phone or (701)-857-5117 by fax.
Equal Opportunity Employment
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.