Apply with Advanced Care Providers
Print & ReturnApply using the included forms below. Click on the form links, documents will appear as PDF’s. Download, print, complete and return all documents plus a current CV to us by email (mike@acpstaff.com) or fax 323-375-3290. Required Forms:ACP Application If additional space is needed, here are some blank work sheets for you to use: Practice History The forms here will not pertain to everyone – if you refuse a Hep B imunization or have had a +TB test: |
OnlineApply online using our secure application. Follow our easy, step-by-step process where you can complete the application and upload required credentialing documents.
Online Application requires additional forms to be forwarded. Download, print, complete and return all documents plus a current CV to us by email mike@acpstaff.com or fax 323-375-3290. Required Forms: Reference Form |
Transfer credentialing documents quickly and easily from your computer. Send forms required on the credentialing checklist directly to ACP. Credentialing Check List |
PhoneCall an ACP representative to apply today! |
 Deb Sanfilippo
715-892-0392 |
 Mike Tonne
715-661-0030 |
