Credentialing

IPA Physician Package

• Application Instructions (FMC-IPA 2011)
  • Adobe PDF
  • Word Document


• Credentialing Application
  • Adobe PDF
  • Word Document
    • Credentialing Application Main
    • Credentialing Application Addendum A
    • Credentialing Application Addendum B


• IPA Stock Consent Disclosure
  • Adobe PDF
  • Word Document


• IPA Stock Offer Exhibit A, and Exhibit B
  • Adobe PDF
  • Word Document


• Addendum to Exhibit B
  • Adobe PDF
  • Word Document


• IPA Stock Offer Exhibit C
  • Adobe PDF
  • Word Document


• PCP Scope Of Service
  • Adobe PDF
  • Word Document


• W9 Form
  • Adobe PDF