Hospital Privilege ApplicationCurrently selected Presbyterian Health Plan Letter of Interest Presbyterian Delivery System Hospital Credentials Verification Organization (CVO) Initial Application RequestPay Hospital Application FeeHelpful ResourcesHospital Privilege ApplicationCurrently selected Home|Providers|Our Networks|Presbyterian Delivery System|Hospital Credentials Verification Organization (CVO)|Hospital Privilege Application|Correction to Submitted Application Correction to Submitted Application Page Image Page Content Please complete the form below. * = indicates required fields First Name* Middle Initial/Name Last Name* Degree/Title* Date of Birth* mm 1 2 3 4 5 6 7 8 9 10 11 12 dd 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 yyyy Preferred Contact Information for Applicant Email Address* Phone#* Fax# Select Presbyterian Facility* Presbyterian Hospital/Kaseman/Rust Medical Center (Albuquerque/Rio Rancho) Plains Regional Medical Center (Clovis) Dan C. Trigg Memorial Hospital (Tucumcari) Española Hospital (Española) Lincoln County Medical Center (Ruidoso) Socorro General Hospital (Socorro) Information to be Corrected Work History Education Licensure/Certificates Insurance Malpractice/Claims/Criminal History Professional Practice Questions (PPQs) The control cannot be rendered without valid Public and Private keys. Additional Content Back To Top Sidebar Content