Credentialing Requirements

TTG Locum Tenens, Inc. must have the following documents from you in order to provide professional liability insurance coverage, and to schedule you for TTG Locum Tenens assignments.

1. TTG Locum Tenens, Inc. Application Form – completed and signed on the last two pages. (Remember to include any explanations required, as well as your CME list.)

2. W-9 Tax Form & I-9 Form – completed and signed.

Copies of your:

3. State Medical License(s).

4. State Controlled Substance Certificate(s).

5. Federal Drug Enforcement Administration (DEA) Certificate.

6. Medical School Diploma.

7. Internship, Residency and Fellowship Certificates.

8. Medical Board Certificate(s), if you are Board Certified.

9. Current Curriculum Vitae.

10. Reference Form - Three completed Professional References Forms. (You distribute these, and then you references will send them to us.

11. ACLS, ATLS, PALS, PACTS, PTLS Certificates.

If , you graduated from a foreign medical school include:

12. ECFMG Certificate.

And if you are not a United States Citizen include:

13. Visa, Alien Registration, or Work Permit.